{"id":"https://openalex.org/W3195810179","doi":"https://doi.org/10.1097/ncq.0000000000000588","title":"Comparing Methods of Identifying Outlying Nurses in Audits of Low-Risk Cesarean Delivery Rates","display_name":"Comparing Methods of Identifying Outlying Nurses in Audits of Low-Risk Cesarean Delivery Rates","publication_year":2021,"publication_date":"2021-08-24","ids":{"openalex":"https://openalex.org/W3195810179","doi":"https://doi.org/10.1097/ncq.0000000000000588","mag":"3195810179","pmid":"https://pubmed.ncbi.nlm.nih.gov/34446663"},"language":"en","primary_location":{"id":"doi:10.1097/ncq.0000000000000588","doi":"https://doi.org/10.1097/ncq.0000000000000588","is_oa":false,"landing_page_url":"https://doi.org/10.1097/ncq.0000000000000588","pdf_url":null,"source":{"id":"https://openalex.org/S96868337","display_name":"Journal of Nursing Care Quality","issn_l":"1057-3631","issn":["1057-3631","1550-5065"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Nursing Care Quality","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5066185227","display_name":"Joyce K. Edmonds","orcid":"https://orcid.org/0000-0002-0465-9043","observed_orcids":["https://orcid.org/0000-0002-0465-9043"]},"institutions":[{"id":"https://openalex.org/I103531236","display_name":"Boston College","ror":"https://ror.org/02n2fzt79","country_code":"US","type":"education","lineage":["https://openalex.org/I103531236"]},{"id":"https://openalex.org/I1282927834","display_name":"Cedars-Sinai Medical Center","ror":"https://ror.org/02pammg90","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1282927834"]},{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4405272099","display_name":"Ariadne Labs","ror":"https://ror.org/03jfmeb59","country_code":"US","type":"facility","lineage":["https://openalex.org/I4405272099"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Joyce K. Edmonds","raw_affiliation_strings":["Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds); Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah); Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell); Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","Accepted for publication: July 6, 2021","Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","Early Access: August 24, 2021","Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","The authors declare no conflicts of interest","This study was funded by a grant from the Rx Foundation"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds); Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah); Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell); Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","institution_ids":["https://openalex.org/I103531236","https://openalex.org/I1282927834","https://openalex.org/I1316535847","https://openalex.org/I136199984","https://openalex.org/I4405272099"]},{"raw_affiliation_string":"Accepted for publication: July 6, 2021","institution_ids":[]},{"raw_affiliation_string":"Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","institution_ids":["https://openalex.org/I103531236"]},{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I136199984"]},{"raw_affiliation_string":"Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","institution_ids":["https://openalex.org/I1282927834"]},{"raw_affiliation_string":"Early Access: August 24, 2021","institution_ids":[]},{"raw_affiliation_string":"Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","institution_ids":["https://openalex.org/I4405272099"]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","institution_ids":[]},{"raw_affiliation_string":"The authors declare no conflicts of interest","institution_ids":[]},{"raw_affiliation_string":"This study was funded by a grant from the Rx Foundation","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5048284268","display_name":"Samuel R. Woodbury","orcid":"https://orcid.org/0000-0002-8146-3378","observed_orcids":["https://orcid.org/0000-0002-8146-3378"]},"institutions":[{"id":"https://openalex.org/I103531236","display_name":"Boston College","ror":"https://ror.org/02n2fzt79","country_code":"US","type":"education","lineage":["https://openalex.org/I103531236"]},{"id":"https://openalex.org/I1282927834","display_name":"Cedars-Sinai Medical Center","ror":"https://ror.org/02pammg90","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1282927834"]},{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4405272099","display_name":"Ariadne Labs","ror":"https://ror.org/03jfmeb59","country_code":"US","type":"facility","lineage":["https://openalex.org/I4405272099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Samuel R. Woodbury","raw_affiliation_strings":["Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","Accepted for publication: July 6, 2021","Early Access: August 24, 2021","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","The authors declare no conflicts of interest","This study was funded by a grant from the Rx Foundation"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","institution_ids":["https://openalex.org/I103531236"]},{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I136199984"]},{"raw_affiliation_string":"Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","institution_ids":["https://openalex.org/I1282927834"]},{"raw_affiliation_string":"Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","institution_ids":["https://openalex.org/I4405272099"]},{"raw_affiliation_string":"Accepted for publication: July 6, 2021","institution_ids":[]},{"raw_affiliation_string":"Early Access: August 24, 2021","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","institution_ids":[]},{"raw_affiliation_string":"The authors declare no conflicts of interest","institution_ids":[]},{"raw_affiliation_string":"This study was funded by a grant from the Rx Foundation","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5076886998","display_name":"Stuart R. Lipsitz","orcid":"https://orcid.org/0000-0003-2619-1389","observed_orcids":["https://orcid.org/0000-0003-2619-1389"]},"institutions":[{"id":"https://openalex.org/I103531236","display_name":"Boston College","ror":"https://ror.org/02n2fzt79","country_code":"US","type":"education","lineage":["https://openalex.org/I103531236"]},{"id":"https://openalex.org/I1282927834","display_name":"Cedars-Sinai Medical Center","ror":"https://ror.org/02pammg90","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1282927834"]},{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4405272099","display_name":"Ariadne Labs","ror":"https://ror.org/03jfmeb59","country_code":"US","type":"facility","lineage":["https://openalex.org/I4405272099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Stuart R. Lipsitz","raw_affiliation_strings":["Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","Accepted for publication: July 6, 2021","Early Access: August 24, 2021","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","The authors declare no conflicts of interest","This study was funded by a grant from the Rx Foundation"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","institution_ids":["https://openalex.org/I103531236"]},{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I136199984"]},{"raw_affiliation_string":"Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","institution_ids":["https://openalex.org/I1282927834"]},{"raw_affiliation_string":"Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","institution_ids":["https://openalex.org/I4405272099"]},{"raw_affiliation_string":"Accepted for publication: July 6, 2021","institution_ids":[]},{"raw_affiliation_string":"Early Access: August 24, 2021","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","institution_ids":[]},{"raw_affiliation_string":"The authors declare no conflicts of interest","institution_ids":[]},{"raw_affiliation_string":"This study was funded by a grant from the Rx Foundation","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5051097025","display_name":"Amber Weiseth","orcid":"https://orcid.org/0000-0001-9424-8354","observed_orcids":["https://orcid.org/0000-0001-9424-8354"]},"institutions":[{"id":"https://openalex.org/I103531236","display_name":"Boston College","ror":"https://ror.org/02n2fzt79","country_code":"US","type":"education","lineage":["https://openalex.org/I103531236"]},{"id":"https://openalex.org/I1282927834","display_name":"Cedars-Sinai Medical Center","ror":"https://ror.org/02pammg90","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1282927834"]},{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4405272099","display_name":"Ariadne Labs","ror":"https://ror.org/03jfmeb59","country_code":"US","type":"facility","lineage":["https://openalex.org/I4405272099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Amber Weiseth","raw_affiliation_strings":["Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","Accepted for publication: July 6, 2021","Early Access: August 24, 2021","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","The authors declare no conflicts of interest","This study was funded by a grant from the Rx Foundation"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","institution_ids":["https://openalex.org/I103531236"]},{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I136199984"]},{"raw_affiliation_string":"Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","institution_ids":["https://openalex.org/I1282927834"]},{"raw_affiliation_string":"Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","institution_ids":["https://openalex.org/I4405272099"]},{"raw_affiliation_string":"Accepted for publication: July 6, 2021","institution_ids":[]},{"raw_affiliation_string":"Early Access: August 24, 2021","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","institution_ids":[]},{"raw_affiliation_string":"The authors declare no conflicts of interest","institution_ids":[]},{"raw_affiliation_string":"This study was funded by a grant from the Rx Foundation","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103756920","display_name":"Maureen E. Farrell","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I103531236","display_name":"Boston College","ror":"https://ror.org/02n2fzt79","country_code":"US","type":"education","lineage":["https://openalex.org/I103531236"]},{"id":"https://openalex.org/I1282927834","display_name":"Cedars-Sinai Medical Center","ror":"https://ror.org/02pammg90","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1282927834"]},{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4405272099","display_name":"Ariadne Labs","ror":"https://ror.org/03jfmeb59","country_code":"US","type":"facility","lineage":["https://openalex.org/I4405272099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Maureen E. Farrell","raw_affiliation_strings":["Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","Accepted for publication: July 6, 2021","Early Access: August 24, 2021","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","The authors declare no conflicts of interest","This study was funded by a grant from the Rx Foundation"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","institution_ids":["https://openalex.org/I103531236"]},{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I136199984"]},{"raw_affiliation_string":"Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","institution_ids":["https://openalex.org/I1282927834"]},{"raw_affiliation_string":"Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","institution_ids":["https://openalex.org/I4405272099"]},{"raw_affiliation_string":"Accepted for publication: July 6, 2021","institution_ids":[]},{"raw_affiliation_string":"Early Access: August 24, 2021","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","institution_ids":[]},{"raw_affiliation_string":"The authors declare no conflicts of interest","institution_ids":[]},{"raw_affiliation_string":"This study was funded by a grant from the Rx Foundation","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5069853037","display_name":"Neel T. Shah","orcid":"https://orcid.org/0000-0002-8971-7627","observed_orcids":["https://orcid.org/0000-0002-8971-7627"]},"institutions":[{"id":"https://openalex.org/I103531236","display_name":"Boston College","ror":"https://ror.org/02n2fzt79","country_code":"US","type":"education","lineage":["https://openalex.org/I103531236"]},{"id":"https://openalex.org/I1282927834","display_name":"Cedars-Sinai Medical Center","ror":"https://ror.org/02pammg90","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1282927834"]},{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4405272099","display_name":"Ariadne Labs","ror":"https://ror.org/03jfmeb59","country_code":"US","type":"facility","lineage":["https://openalex.org/I4405272099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Neel T. Shah","raw_affiliation_strings":["Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","Accepted for publication: July 6, 2021","Early Access: August 24, 2021","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","The authors declare no conflicts of interest","This study was funded by a grant from the Rx Foundation"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","institution_ids":["https://openalex.org/I103531236"]},{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I136199984"]},{"raw_affiliation_string":"Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","institution_ids":["https://openalex.org/I1282927834"]},{"raw_affiliation_string":"Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","institution_ids":["https://openalex.org/I4405272099"]},{"raw_affiliation_string":"Accepted for publication: July 6, 2021","institution_ids":[]},{"raw_affiliation_string":"Early Access: August 24, 2021","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","institution_ids":[]},{"raw_affiliation_string":"The authors declare no conflicts of interest","institution_ids":[]},{"raw_affiliation_string":"This study was funded by a grant from the Rx Foundation","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031770873","display_name":"Naomi Greene","orcid":"https://orcid.org/0000-0001-5216-3539","observed_orcids":["https://orcid.org/0000-0001-5216-3539"]},"institutions":[{"id":"https://openalex.org/I103531236","display_name":"Boston College","ror":"https://ror.org/02n2fzt79","country_code":"US","type":"education","lineage":["https://openalex.org/I103531236"]},{"id":"https://openalex.org/I1282927834","display_name":"Cedars-Sinai Medical Center","ror":"https://ror.org/02pammg90","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1282927834"]},{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4405272099","display_name":"Ariadne Labs","ror":"https://ror.org/03jfmeb59","country_code":"US","type":"facility","lineage":["https://openalex.org/I4405272099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Naomi Greene","raw_affiliation_strings":["Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","Accepted for publication: July 6, 2021","Early Access: August 24, 2021","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","The authors declare no conflicts of interest","This study was funded by a grant from the Rx Foundation"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","institution_ids":["https://openalex.org/I103531236"]},{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I136199984"]},{"raw_affiliation_string":"Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","institution_ids":["https://openalex.org/I1282927834"]},{"raw_affiliation_string":"Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","institution_ids":["https://openalex.org/I4405272099"]},{"raw_affiliation_string":"Accepted for publication: July 6, 2021","institution_ids":[]},{"raw_affiliation_string":"Early Access: August 24, 2021","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","institution_ids":[]},{"raw_affiliation_string":"The authors declare no conflicts of interest","institution_ids":[]},{"raw_affiliation_string":"This study was funded by a grant from the Rx Foundation","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5038171106","display_name":"Kimberly D. Gregory","orcid":"https://orcid.org/0000-0003-2313-9200","observed_orcids":["https://orcid.org/0000-0003-2313-9200"]},"institutions":[{"id":"https://openalex.org/I103531236","display_name":"Boston College","ror":"https://ror.org/02n2fzt79","country_code":"US","type":"education","lineage":["https://openalex.org/I103531236"]},{"id":"https://openalex.org/I1282927834","display_name":"Cedars-Sinai Medical Center","ror":"https://ror.org/02pammg90","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1282927834"]},{"id":"https://openalex.org/I1316535847","display_name":"Beth Israel Deaconess Medical Center","ror":"https://ror.org/04drvxt59","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1316535847"]},{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4405272099","display_name":"Ariadne Labs","ror":"https://ror.org/03jfmeb59","country_code":"US","type":"facility","lineage":["https://openalex.org/I4405272099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kimberly D. Gregory","raw_affiliation_strings":["Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","Accepted for publication: July 6, 2021","Early Access: August 24, 2021","Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","The authors declare no conflicts of interest","This study was funded by a grant from the Rx Foundation"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts (Dr Edmonds)","institution_ids":["https://openalex.org/I103531236"]},{"raw_affiliation_string":"Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, Massachusetts (Dr Farrell)","institution_ids":["https://openalex.org/I1316535847","https://openalex.org/I136199984"]},{"raw_affiliation_string":"Division of Maternal Fetal Medicine (Dr Gregory), Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California (Dr Greene)","institution_ids":["https://openalex.org/I1282927834"]},{"raw_affiliation_string":"Science and Technology, Ariadne Labs, Boston, Massachusetts (Mr Woodbury and Drs Lipsitz, Weiseth, and Shah)","institution_ids":["https://openalex.org/I4405272099"]},{"raw_affiliation_string":"Accepted for publication: July 6, 2021","institution_ids":[]},{"raw_affiliation_string":"Early Access: August 24, 2021","institution_ids":[]},{"raw_affiliation_string":"Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com)","institution_ids":[]},{"raw_affiliation_string":"The authors declare no conflicts of interest","institution_ids":[]},{"raw_affiliation_string":"This study was funded by a grant from the Rx Foundation","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5066185227"],"corresponding_institution_ids":["https://openalex.org/I103531236","https://openalex.org/I1282927834","https://openalex.org/I1316535847","https://openalex.org/I136199984","https://openalex.org/I4405272099"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":2,"citation_normalized_percentile":{"value":0.17768659,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":94,"max":96},"biblio":{"volume":"37","issue":"2","first_page":"149","last_page":"154"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10453","display_name":"Maternal and Perinatal Health Interventions","score":0.6801999807357788,"subfield":{"id":"https://openalex.org/subfields/2729","display_name":"Obstetrics and Gynecology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10453","display_name":"Maternal and Perinatal Health Interventions","score":0.6801999807357788,"subfield":{"id":"https://openalex.org/subfields/2729","display_name":"Obstetrics and Gynecology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.22220000624656677,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12443","display_name":"Delphi Technique in Research","score":0.041600000113248825,"subfield":{"id":"https://openalex.org/subfields/3312","display_name":"Sociology and Political Science"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/nurse-performance","display_name":"nurse performance","score":0.609000027179718},{"id":"https://openalex.org/keywords/outlier-detection","display_name":"outlier detection","score":0.859000027179718},{"id":"https://openalex.org/keywords/risk-adjustment","display_name":"risk adjustment","score":0.9459999799728394},{"id":"https://openalex.org/keywords/maternity-care","display_name":"obstetric care","score":0.6060000061988831},{"id":"https://openalex.org/keywords/quality-improvement","display_name":"quality improvement","score":0.6019999980926514},{"id":"https://openalex.org/keywords/performance-indicators","display_name":"performance indicators","score":0.49399998784065247},{"id":"https://openalex.org/keywords/benchmarking","display_name":"benchmarking","score":0.5860000252723694}],"concepts":[{"id":"https://openalex.org/C147021879","wikidata":"https://www.wikidata.org/wiki/Q3027971","display_name":"Decile","level":2,"score":0.7593200206756592},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5930931568145752},{"id":"https://openalex.org/C79337645","wikidata":"https://www.wikidata.org/wiki/Q779824","display_name":"Outlier","level":2,"score":0.5371763110160828},{"id":"https://openalex.org/C199521495","wikidata":"https://www.wikidata.org/wiki/Q181487","display_name":"Audit","level":2,"score":0.5353448987007141},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.5230425596237183},{"id":"https://openalex.org/C189430467","wikidata":"https://www.wikidata.org/wiki/Q7293293","display_name":"Ranking (information retrieval)","level":2,"score":0.46500810980796814},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.42714163661003113},{"id":"https://openalex.org/C71405471","wikidata":"https://www.wikidata.org/wiki/Q757012","display_name":"Quality management","level":3,"score":0.42069071531295776},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.4130091369152069},{"id":"https://openalex.org/C105795698","wikidata":"https://www.wikidata.org/wiki/Q12483","display_name":"Statistics","level":1,"score":0.273465633392334},{"id":"https://openalex.org/C21547014","wikidata":"https://www.wikidata.org/wiki/Q1423657","display_name":"Operations management","level":1,"score":0.16290277242660522},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.1568220555782318},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.10835963487625122},{"id":"https://openalex.org/C121955636","wikidata":"https://www.wikidata.org/wiki/Q4116214","display_name":"Accounting","level":1,"score":0.0793670117855072},{"id":"https://openalex.org/C33923547","wikidata":"https://www.wikidata.org/wiki/Q395","display_name":"Mathematics","level":0,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.0},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.0},{"id":"https://openalex.org/C198783460","wikidata":"https://www.wikidata.org/wiki/Q629173","display_name":"Management system","level":2,"score":0.0},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D002585","descriptor_name":"Cesarean Section","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008427","descriptor_name":"Maternal Health Services","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011247","descriptor_name":"Pregnancy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012189","descriptor_name":"Retrospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015331","descriptor_name":"Cohort Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D058996","descriptor_name":"Quality Improvement","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1097/ncq.0000000000000588","doi":"https://doi.org/10.1097/ncq.0000000000000588","is_oa":false,"landing_page_url":"https://doi.org/10.1097/ncq.0000000000000588","pdf_url":null,"source":{"id":"https://openalex.org/S96868337","display_name":"Journal of Nursing Care Quality","issn_l":"1057-3631","issn":["1057-3631","1550-5065"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Nursing Care Quality","raw_type":"journal-article"},{"id":"pmid:34446663","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/34446663","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of nursing care quality","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.9763000011444092,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":21,"referenced_works":["https://openalex.org/W1896301035","https://openalex.org/W2014176603","https://openalex.org/W2083043137","https://openalex.org/W2083515984","https://openalex.org/W2105501846","https://openalex.org/W2129159506","https://openalex.org/W2164777277","https://openalex.org/W2203750246","https://openalex.org/W2284918304","https://openalex.org/W2436496303","https://openalex.org/W2550372265","https://openalex.org/W2617465955","https://openalex.org/W2769229938","https://openalex.org/W2805105613","https://openalex.org/W2941804823","https://openalex.org/W2997796339","https://openalex.org/W3016760168","https://openalex.org/W3049885345","https://openalex.org/W3081174711","https://openalex.org/W3120269661","https://openalex.org/W4254121596"],"related_works":["https://openalex.org/W3081174711","https://openalex.org/W1964439613","https://openalex.org/W2617465955","https://openalex.org/W2062182670","https://openalex.org/W2099532145","https://openalex.org/W2080479235","https://openalex.org/W10527348","https://openalex.org/W4394849052","https://openalex.org/W1980790591","https://openalex.org/W7112805138"],"abstract_inverted_index":{"BACKGROUND:":[0],"The":[1],"low-risk":[2],"cesarean":[3],"delivery":[4],"(CD)":[5],"rate":[6],"is":[7],"an":[8],"established":[9],"performance":[10,28],"indicator":[11],"for":[12,17],"providers":[13],"in":[14,57],"maternity":[15,60],"care":[16],"quality":[18],"improvement":[19],"purposes.":[20],"PURPOSE:":[21],"Our":[22],"objectives":[23],"were":[24,68,115],"to":[25,35,92,101,129,141],"assess":[26],"nurse":[27,40,134,143],"using":[29],"adjusted":[30],"nurse-level":[31,65,86],"CD":[32,66,87],"rates":[33,67,88,97],"and":[34,63,70,94,113,126],"compare":[36],"methods":[37],"of":[38,49,81,111],"identifying":[39],"outliers.":[41,135],"METHODS:":[42],"We":[43],"conducted":[44],"a":[45,79],"retrospective,":[46],"cohort":[47],"study":[48],"6970":[50],"births":[51],"attended":[52],"by":[53,118],"181":[54],"registered":[55],"nurses":[56],"one":[58],"hospital's":[59],"unit.":[61],"Adjusted":[62,85],"unadjusted":[64,96],"compared":[69],"agreement":[71],"between":[72,123],"3":[73,119],"definitions":[74],"(statistical,":[75],"top":[76],"decile,":[77],"over":[78],"benchmark)":[80],"outliers":[82,114],"calculated.":[83],"RESULTS:":[84],"varied":[89,98],"from":[90,99],"5.5%":[91],"53.2%,":[93],"the":[95,109],"5%":[100],"50%.":[102],"Risk":[103],"adjustment":[104],"had":[105],"little":[106],"impact":[107],"on":[108],"ranking":[110],"nurses,":[112],"consistently":[116],"identified":[117],"definitions.":[120],"CONCLUSIONS:":[121],"Trade-offs":[122],"statistical":[124],"certainty":[125],"feasibility":[127],"need":[128],"be":[130],"considered":[131],"when":[132],"classifying":[133],"Findings":[136],"can":[137],"help":[138],"target":[139],"interventions":[140],"improve":[142],"performance.":[144]},"counts_by_year":[{"year":2025,"cited_by_count":2}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2021-08-30T00:00:00"}