South African Family Practice

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Quality Improvement: Appropriate episiotomies in a district hospital

L Di Mattia, JFM Hugo


Work satisfaction, enthusiasm and better patient care at times come from the simplest things. Quite a number of patients were coming with episiotomy dehiscence (gaping episiotomy) to the Taung Hospital. Most of them were primigravidae, on whom a routine episiotomy (according to the Hospital policy) had been performed.

A literature review showed that there routine episiotomy was not necessary, and that reducing the number of episiotomies had not increased the number of complications for the mothers or babies.

A multidisciplinary team did a quality improvement project to reduce the number of episiotomies. The results of the project were positive: the episiotomy rate decreased from 66,2% to 25,3% and the episiotomy dehiscence rate dropped from 2.28% to 0.7%. This had a positive impact also on patient satisfaction and staff morale. The experience is described as a quality improvement cycle and discussed in light of some principles of quality improvement in a rural hospital.

SA Fam Pract 2033;45(6):17-19

Keywords: quality, team, satisfaction, care, improvement

AJOL African Journals Online