Maternal morbidity indicators

The Commission has developed a range of indicators to support measurement in the maternity setting.

Severe acute maternal morbidity indicators

The severe acute maternal morbidity (SAMM) indicators were developed to support the local capture and review of SAMM events and to allow hospitals to monitor and implement safety and quality improvement strategies relating to severe maternal incidents.  

The SAMM indicators include clinical definitions and code combinations. The SAMM clinical definitions were developed as a primary way to consistently identify high priority SAMM events. The code combinations were added as an additional mechanism to identify SAMM events through the use of routinely collected data. 

Hospital-acquired complications 

The hospital-acquired complications (HACs) list includes an indicator to identify third and fourth degree perineal laceration during delivery.

Recommendations on the SAMM indicators 

The working group that supported the development of the SAMM indicators made these recommendations:

  1. All cases of SAMM should be routinely reviewed and reported at a local hospital level
  2. Documented and de-identified reviews of SAMM should inform a feedback loop of broader system learning beyond the facility or jurisdiction where the incident took place
  3. That post partum haemorrhage data are captured and reported routinely as part of jurisdictional and national perinatal and midwife data collections.

In 2016, Australian Health Ministers' Advisory Council supported the recommendations. Recommendation 2 forms part of the Commission's current work plan.

Development of the SAMM indicators 

In June 2013, the Commission formed the Maternal Sentinel Event and Post Partum Haemorrhage Working Group, an expert, time-limited group, comprised of members from identified specialist groups and safety and quality experts. The role of the working group was to respond safety issues reported through the Commission’s Inter-Jurisdictional Committee. The development of the SAMM indicators was supported by this group.