Can hospital audit teams identify case management problems, analyse their causes, identify and implement improvements? A cross-sectional process evaluation of obstetric near-miss case reviews in Benin

Table 9 Appropriateness of CMP cause identified by audit team, by type and severity of CMP

Type of CMP	CMP identified?		Cause identified?		Cause plausible?		Cause profound?		Cause within reach?		Cause identified and plausible and profound and within reach?
*By type of CMP*	*Yes*	*p<0.0005* ^#	*Yes*	*p=0.085*	*Yes*	*p=0.013*	*Yes*	*p=0.016*	*Yes*	*p=0.009*	*Yes*	*p=0.071*
referral to hospital	37/42	88.1%	23/26*	88.5%	20/23	87.0%	9/20	45.0%	16/20	80.0%	8/37	21.6%
establishing the diagnosis	95/170	55.9%	84/94*	89.4%	83/84	98.8%	27/83	32.5%	73/83	88.0%	17/95	17.9%
treatment of complication	76/250	30.4%	61/72*	84.7%	58/61	95.1%	35/58	60.3%	47/58	81.0%	25/76	32.9%
interacting with the patient	58/98	59.2%	40/55*	72.7%	40/40	100.0%	14/40	35.0%	36/40	90.0%	10/58	17.2%
management of hospital	97/136	71.3%	73/94*	77.7%	73/73	100.0%	25/73	34.3%	72/73	98.6%	24/97	24.7%
other	13/18	72.2%	12/13	92.3%	12/12	100.0%	6/12	50.0%	12/12	100.0%	6/7	46.2%
Total	376/714	52.7%	293/354*	82.8%	286/293	97.6%	116/286	40.6%	256/286	89.5%	90/376	23.9%
*By severity of CMP*	*Yes*	*p=0.31* ^#	*Yes*	*p=0.009*	*Yes*	*p=0.57*	*Yes*	*p=0.055*	*Yes*	*p=0.25*	*Yes*	*p=0.001*
minor	183/329	55.6%	131/172*	76.2%	129/131	98.5%	43/129	33.3%	115/129	89.2%	30/183	16.4%
intermediate	144/285	50.5%	119/135*	88.2%	115/119	96.6%	51/115	44.4%	102/115	88.7%	40/144	27.8%
major	44/91	48.4%	39/43*	90.7%	38/39	97.4%	20/38	52.6%	35/38	92.1%	18/44	40.9%
Total	371/705 ^&	52.6%	289/350*	82.6%	282/289	97.6%	114/282	40.4%	252/282	89.4%	88/371	23.7%

^#: p-values derived from chi²-test; all other p-values derived from Fisher’s exact test.
* N smaller than expected due to missing data.
^& N smaller than expected due to disagreement among external assessors on severity of CMP.

ISSN: 1471-2393