Project Summary

This implementation project is complete.

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

This PCORI-funded implementation project put a childbirth experience survey in place at 16 diverse hospitals in California.

Hospitals often use surveys to understand how patients experience care. They can use the information to improve care for patients and their families. But these surveys usually ask general questions and may not provide helpful information about the experience of childbirth.

What was the goal of this implementation project?

To help hospitals learn about patients’ experiences with their care during and after childbirth, a PCORI-funded research study developed a set of questions that hospitals can draw from to create surveys. The research team then developed the Childbirth Experience Survey using these questions.

This project helped hospitals put the Childbirth Experience Survey in place to support improved care for patients during and after childbirth.

What did this project do?

The project team put the survey in place at 16 diverse hospitals in California. Before childbirth, patients reported what parts of care were important to them. Two to three months after childbirth, patients reported on their experience and satisfaction with their care. The survey was available in English and Spanish.

As part of the project, the project team:

  • Created an online platform to collect answers to survey questions from the different hospitals.
  • Worked with hospitals to identify patients from childbirth classes, hospital tours, or delivery registration lists and enroll them as survey participants.
  • Provided reports with survey responses to each hospital and showed how hospitals could use the information to improve care.
  • Created a learning collaborative where hospitals learned from one another about how to use results from the survey.

The project team also updated the survey to ask about care during the COVID-19 pandemic.

What was the impact of this project?

The project demonstrated how hospitals can use the survey to collect information about patients’ childbirth experience. During the project, 1,803 patients completed surveys. More than 440 patients completed surveys both before and after childbirth.

The survey results helped hospital staff learn about childbirth practices at their hospitals. For example, most hospital staff thought that the practice of placing newborns skin-to-skin with the birthing parent happened regularly. But survey responses suggested that this practice didn’t occur as often as hospital staff thought.

Hospitals used the survey results to improve care. At one hospital, the survey found patient concerns with the quality of epidurals. This hospital started a project to look at epidurals and track patient satisfaction with this part of care.

More about this implementation project:

Stakeholders Involved in This Project

  • The Childbirth Patient-Reported Outcomes Partnership, a group of researchers, care providers, birthing people, advocates, hospital quality experts, and senior administrators.
  • Mahmee, an integrated care delivery platform for maternal and infant health, provided the online platform for data collection.

Publicly Accessible Project Materials

  • Flyers with QR code
  • Postcards with QR code
  • Referral cards
  • Patient contact letter
  • FAQs sheet
  • Project introduction script
  • Volunteer script
  • "How to use a QR code" video and one pager

For more information about these materials, please contact the project team at [email protected].

The project team developed these materials, which may be available for free or require a fee to access. Please note that the materials do not necessarily represent the views of PCORI and that PCORI cannot guarantee their accuracy or reliability.

Project Achievements

  • Developed a data collection process to collect childbirth experience data tailored to each participating hospital
  • Demonstrated feasibility of survey recruitment, completion, and analysis
  • Surveyed 1,803 patients in 16 diverse California hospitals
  • Confirmed interest in joining a learning collaborative for hospitals to support their use of the survey and to identify opportunities for improving patients’ childbirth experience

Implementation Strategies

  • Assessed for readiness at participating hospitals
  • Adapted the survey to work with sites’ existing workflows and resources, to support in-person and virtual recruitment, and to translate it into Spanish.
  • Provided hospitals with tools to support implementation, including flyers, referral cards, FAQ sheets, and communication scripts
  • Trained hospital staff and volunteers to support survey recruitment and to use the survey data collection platform
  • Identified and prepared champions at sites to promote use of the survey
  • Conducted site visits
  • Provided hospitals with audit and feedback reports
  • Provided technical assistance to hospitals, including ongoing consultation and performance feedback
  • Created a learning collaborative to discuss implementation issues, barriers, challenges, and successes to support use of the survey

Evaluation Measures

To document implementation:

  • Readiness assessment
  • Number of completed surveys

To assess healthcare and health outcomes:

  • Self-reported personal characteristics and clinical data
  • Values and preferences related to the experience of childbirth
  • Patient-reported outcomes related to care experience and communication
  • The gap between patient values and preferences and reported outcomes and experiences

Project Information

Kimberly D. Gregory, MD, MPH
Cedars-Sinai Medical Center
Implementation of Childbirth-Specific Patient-Reported Outcomes Measures in the Hospital Setting

Key Dates

June 2022

Study Registration Information

Initial PCORI-Funded Research Study

This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Developing an Item Bank of Survey Questions to Measure Women's Experiences with Childbirth in Hospitals


Project Status
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
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Last updated: April 12, 2023