Hospital Quality Metrics

When a family is expecting a baby or recovering from a difficult birth, understanding how hospitals measure and report the quality of their maternity care can feel overwhelming. Yet these metrics matter. Hospital quality metrics are standardized measures that help patients, providers, and public health officials evaluate how well a hospital delivers safe, effective, and compassionate care during pregnancy, labor, delivery, and the postpartum period.

For families concerned about birth injuries or seeking the safest possible care, quality metrics offer a window into how hospitals perform on maternal and newborn outcomes, how consistently they follow evidence-based practices, and whether they are actively working to reduce complications and improve patient experiences. This page explains what hospital quality metrics are, which ones matter most for maternity and newborn care, how they connect to birth injury prevention, and how families in New York can use this information when making care decisions.

What Are Hospital Quality Metrics And Why Do They Matter?

Hospital quality metrics are data-driven measures used to assess how well hospitals provide care across multiple dimensions: safety, effectiveness, patient-centeredness, timeliness, equity, and efficiency. These metrics can track patient outcomes (such as rates of severe complications or unexpected transfers to intensive care), adherence to clinical guidelines (like appropriate timing of cesarean deliveries), and patient-reported experiences (including whether families felt respected and informed during their care).

For maternity care specifically, quality metrics focus on the health and safety of both the pregnant person and the baby. They help identify hospitals that consistently achieve better outcomes, follow recommended practices, and provide supportive, dignified care. When hospitals publicly report these metrics, families gain the ability to compare facilities and make more informed choices about where to deliver.

Quality metrics also drive improvement. Hospitals use their own data to identify problem areas, implement safety protocols, and participate in collaborative quality improvement networks. In New York, many hospitals work with perinatal quality collaboratives and public health initiatives that use standardized metrics to reduce severe maternal morbidity, lower rates of preventable complications, and address disparities in care.

How Do Major Health Organizations Define Quality Maternity Care?

Several leading health organizations have developed frameworks to define and measure quality in maternal and newborn care. The World Health Organization defines quality maternity care as care that is effective, safe, people-centered, timely, equitable, integrated, and efficient. The WHO framework includes eight core domains that cover not only the medical provision of care but also the experience of care and the availability of essential resources like trained staff, equipment, and medications.

Within these domains, the WHO has created detailed standards that translate into measurable quality indicators. These include everything from the percentage of deliveries attended by skilled providers to whether hospitals have protocols for managing postpartum hemorrhage, whether mothers receive clear communication and emotional support, and whether newborns receive appropriate thermal care and early breastfeeding support.

In the United States, frameworks from the Centers for Medicare & Medicaid Services, the Agency for Healthcare Research and Quality, and the National Quality Strategy align closely with the WHO approach. U.S. quality programs emphasize outcome-based measures (like rates of severe complications), patient-reported measures (such as satisfaction and respect during care), and equity-focused measures that reveal whether all patients receive equally high-quality care regardless of race, ethnicity, or socioeconomic status.

What Maternal Outcome Metrics Do Hospitals Track?

Maternal outcome metrics focus on the health and safety of the pregnant person during and after delivery. One of the most important is the rate of severe obstetric complications, which CMS now requires hospitals to report as an electronic clinical quality measure. This metric captures serious events including severe hemorrhage, blood transfusion, hysterectomy, admission to the intensive care unit, sepsis, and maternal death. Hospitals use electronic health record data to calculate their rates, compare themselves to national benchmarks, and implement targeted interventions to reduce these preventable complications.

The Agency for Healthcare Research and Quality provides additional maternal health indicators that help states and health systems monitor trends over time. These indicators track severe maternal morbidity (a composite measure of life-threatening complications), maternal mortality, and related behavioral health conditions such as depression or substance use disorder during pregnancy and postpartum.

New York participates in both national and state-specific maternal health tracking. The New York State Perinatal Quality Collaborative and the New York City Department of Health’s Maternity Hospital Quality Improvement Network monitor hospital-level performance on severe maternal morbidity and mortality, often breaking data down by race and ethnicity to identify and address disparities. These initiatives have been credited with driving measurable improvements in maternal safety across participating hospitals.

What Newborn And Neonatal Outcome Metrics Are Most Important?

Newborn outcome metrics assess the health and safety of babies during the birth hospitalization and the early weeks of life. Key measures include neonatal mortality (death within the first 28 days), intrapartum stillbirth (fetal death during labor), and rates of severe neonatal complications such as unexpected transfers to higher-level neonatal intensive care, birth trauma, respiratory distress, or infections.

Global indicators developed by the WHO and other maternal health organizations emphasize facility-based measures like the percentage of term babies born in good condition, the rate of newborn resuscitation, and whether babies receive appropriate immediate care including thermal protection, early skin-to-skin contact, and timely initiation of breastfeeding.

In New York, quality tracking also includes metrics tied to the state’s perinatal regionalization system. One important measure is the percentage of very low birth weight infants (babies born weighing less than 1,500 grams) who are delivered in hospitals with Level III or Level IV neonatal intensive care units. Research shows that these babies have better outcomes when born in hospitals with specialized NICU capabilities, so this metric serves as both a quality indicator and a system performance measure.

New York also tracks the timeliness of newborn screening samples, rates of preterm birth, and infant mortality. Together, these measures help identify hospitals and regions where newborns may be at higher risk and where quality improvement efforts should be focused.

What Process And Practice Measures Reflect Quality Maternity Care?

In addition to tracking patient outcomes, quality metrics also measure whether hospitals follow evidence-based practices known to improve safety and outcomes. These process measures assess what clinicians do, not just what happens to patients, and they are often easier for hospitals to influence directly through training, protocols, and system changes.

One widely used process measure is the rate of elective deliveries before 39 weeks of pregnancy without medical indication. Delivering babies too early, even by a few weeks, increases the risk of breathing problems, feeding difficulties, and longer hospital stays. National and New York collaboratives have worked intensively to reduce early elective deliveries, and quality data show significant success. Participating New York hospitals achieved a 98 percent reduction in scheduled early deliveries without medical justification.

Another important measure is the cesarean birth rate among low-risk, first-time mothers. This metric, endorsed by the National Quality Forum, helps identify hospitals where cesarean rates may be higher than medically necessary. While cesarean delivery is lifesaving in many situations, unnecessary cesareans carry risks including infection, blood loss, and complications in future pregnancies.

Other process measures include the rate of exclusive breast milk feeding during the birth hospitalization, appropriate use of the partograph (a tool to monitor labor progression), timely administration of medications to prevent postpartum hemorrhage, use of antenatal corticosteroids when preterm delivery is expected, and routine newborn care practices such as delayed cord clamping and readiness for resuscitation.

New York perinatal quality collaboratives also track adherence to standardized protocols for screening and managing opioid use disorder during pregnancy, caring for opioid-exposed newborns, and ensuring consistent prenatal consultation and discharge education. These measures reflect the broader understanding that high-quality care requires not just clinical skills but also systematic, coordinated approaches to complex health and social needs.

How Do Patient Experience And Equity Fit Into Quality Measurement?

Quality maternity care is not only about clinical outcomes and adherence to protocols. It is also about how people experience their care, whether they feel respected and informed, and whether all patients receive equally excellent care regardless of their background.

The WHO framework explicitly treats the experience of care as a quality domain equal in importance to clinical effectiveness and safety. WHO-developed survey tools ask mothers whether they were treated with dignity, whether they could participate in decisions about their care, whether they received clear information, and whether they felt emotionally supported. These patient-reported measures can reveal gaps in communication, respect, and compassionate care that would not show up in clinical data alone.

In the United States, growing attention to equity in maternal health has highlighted that hospital-level quality metrics often mask significant disparities. Research shows that Black mothers and other marginalized patients disproportionately deliver in hospitals with higher rates of severe complications. Even when individual patient risk factors are accounted for, the hospitals serving these communities often have fewer resources, less consistent adherence to safety protocols, and higher rates of preventable harm.

This means that overall hospital quality scores can look acceptable while certain groups of patients experience much worse outcomes. To address this, leading quality improvement initiatives now emphasize collecting and reporting data by race, ethnicity, language, insurance status, and other demographic factors. New York City and New York State perinatal quality collaboratives explicitly track severe maternal morbidity and mortality by race and ethnicity, using this data to design interventions that reduce disparities and ensure that all families receive safe, respectful care.

What Maternity Quality Data Is Publicly Available In New York?

Families seeking information about hospital quality for maternity care can access several public data sources. CMS now publicly reports hospital-level rates of severe obstetric complications through its Provider Data Catalog and Hospital Compare tools. This allows patients and their families to compare hospitals on maternal morbidity and understand which facilities have higher or lower rates of serious complications.

New York State and New York City also maintain publicly available reports and dashboards through the New York State Perinatal Quality Collaborative and the NYC Department of Health Maternity Hospital Quality Improvement Network. These programs use standardized perinatal datasets to track hospital performance on selected quality indicators and share aggregated data with the public and participating hospitals.

While detailed clinician-level quality metrics are generally not publicly posted, many large academic medical centers in New York participate in these collaboratives and maintain internal quality dashboards aligned with national and international maternity quality standards. Hospitals such as NYU Langone, Columbia, Mount Sinai, and Albany Medical Center are active participants in state and national quality improvement work.

The CDC also highlights success stories from perinatal quality collaboratives, including New York’s work on reducing elective early deliveries. These case studies illustrate how metrics drive practice change and improve outcomes at the hospital and system level.

How Do Quality Metrics Relate To Birth Injuries And Complications?

Many birth injuries and adverse perinatal outcomes are directly captured within the hospital quality metrics used by CMS, AHRQ, the WHO, and state programs. Severe maternal morbidity measures include complications such as uterine rupture, severe hemorrhage requiring transfusion or hysterectomy, and injuries related to surgical or anesthesia complications. Neonatal measures include birth trauma, unexpected term transfers to intensive care, intrapartum stillbirths, and early neonatal deaths.

Quality research has shown that widely adopted indicators such as the elective early delivery rate and the low-risk cesarean rate are associated with both maternal and neonatal morbidity. Hospitals with higher rates of unnecessary early deliveries or unnecessary cesareans tend to have higher rates of complications. Conversely, hospitals that perform well on these process measures tend to have better overall safety profiles and lower rates of preventable harm.

For a family seeking information about birth injuries, hospital quality metrics provide evidence-based signals about which facilities systematically monitor and work to reduce severe obstetric complications, unplanned maternal ICU admissions, unexpected term neonatal transfers, intrapartum stillbirths, early neonatal deaths, and preventable surgical or medication errors. While no hospital can eliminate all risk, facilities that track their performance, participate in quality collaboratives, and implement evidence-based safety protocols are more likely to prevent complications and respond effectively when problems arise.

How Can Families Use Quality Metrics When Choosing A Hospital In New York?

Families can use publicly available quality data as one tool in making informed decisions about where to deliver. Reviewing hospital-level performance on maternal health measures in the CMS Provider Data Catalog is a good starting point. Families can also look at New York-specific perinatal initiatives and reports to understand how individual hospitals participate in quality improvement efforts and how they perform on key safety and outcome measures.

New York’s perinatal regionalization system is designed to match patients with the appropriate level of care based on medical risk. Very high-risk pregnancies, including those expected to result in very low birth weight infants, are directed to hospitals with Level III or Level IV NICUs. This matching itself is a quality measure tied to better outcomes, as babies born in hospitals equipped to handle their medical needs from the start have better survival rates and fewer complications.

When evaluating hospitals, families might consider asking questions during prenatal visits or hospital tours about what quality metrics the hospital tracks, how the hospital compares to state and national benchmarks, and what quality improvement initiatives are currently underway. Hospitals that are transparent about their data and actively engaged in quality improvement are often more responsive to patient concerns and more committed to continuous learning and safety.

It is also important to consider the dimensions of quality that are harder to quantify, including how the hospital treats patients with respect, whether staff communicate clearly and compassionately, and whether families feel supported and informed. Quality metrics provide valuable information, but they are most useful when combined with personal factors such as proximity to home, provider relationships, language and cultural support services, and individual medical needs.

At nybirthinjury.com, we provide trusted information to help families understand the medical aspects of birth injuries, hospital quality, and available support resources. While quality metrics offer important insights, every family’s situation is unique. Families with specific concerns about their pregnancy, delivery plan, or a past birth injury may benefit from consulting with their healthcare providers, reviewing hospital quality data, and seeking second opinions when appropriate.

Quality metrics are tools designed to improve care for everyone. By understanding what these measures track, how hospitals use them, and where to find reliable data, families can make more informed decisions and advocate for the safest, most respectful care possible.