The Maternal Newborn Dashboard

Overview

The Maternal Newborn Dashboard is an online audit and feedback tool that provides hospitals and health-care providers across Ontario with near real-time data on maternal and newborn care. The dashboard allows hospitals to track key clinical indicators, compare performance with provincial benchmarks, and identify areas for improvement to support safe, high-quality care for pregnant individuals and babies.

Why This Matters

The Maternal Newborn Dashboard helps hospitals identify areas for improvement and take action to enhance maternal and newborn care. An evaluation using BORN data showed that hospitals using the Dashboard significantly improved on four key indicators. For every 100 individuals there were:

Fewer post-dates inductions: 11.7 fewer inductions done for “post-dates” for pregnant individuals less than 41 weeks at delivery, which lowered the risks of induction-related complications such as increased likelihood of a cesarean birth.
Reduced early elective repeat cesarean births (before 39 weeks): 10.4 fewer elective repeat caesarean births for low-risk individuals less than 39 weeks at delivery (reducing the risks of neonatal respiratory complications as well as significant cost savings).
Improved timing of GBS screening: 2.8 more individuals received group B streptococcus (GBS) screening during pregnancy which led to improved prevention of newborn sepsis (infection)
Fewer episiotomies: 1.5 fewer episiotomies were performed on birthing individuals during a spontaneous vaginal birth lowering the risks of complications after birth

BORN's Role

BORN developed the Maternal Newborn Dashboard through a rigorous, evidence-informed process involving multiple stakeholders. The initiative began with the Maternal Newborn Outcomes Committee, which provided overarching guidance and strategic direction. This committee was instrumental in defining key performance indicators (KPIs) that align with best practices in maternal-newborn care.

To ensure the dashboard's clinical relevance and effectiveness, BORN convened a Dashboard Sub-committee comprising experts in obstetrics, neonatology, and quality improvement. This sub-committee conducted comprehensive evidence reviews to select appropriate KPIs and to design the dashboard's features, ensuring that it would be a valuable tool for hospitals across Ontario.

Following its launch, BORN Ontario has continued to maintain and enhance the dashboard, incorporating feedback from users and stakeholders to refine its functionality and ensure its ongoing utility in monitoring and improving maternal-newborn care across the province.

Impact and Benefits

For Patients

Contributes to safer, higher-quality maternal and newborn care
Encourages consistent best practices across hospitals

For Providers

Near real-time access to key maternal and newborn indicators
Ability to monitor trends and identify areas for improvement
Supports quality improvement initiatives and accreditation requirements

For Healthcare

Supports evidence-informed decision-making
Helps identify provincial trends and target system-wide improvements
Supports care quality by identifying variations and targeting areas needing improvement

Eligibility and Access

The Dashboard is available to all Ontario hospitals providing maternal and newborn care. Hospital staff with appropriate permissions can access the Dashboard through the secure BORN Information System (BIS).

Publications

Reszel J, Dunn SI, Sprague AE, Graham ID, Grimshaw JM, Peterson WE, Ockenden H, Wilding J, Quosdorf A, Darling EK, Fell DB, Harrold J, Lanes A, Smith GN, Taljaard M, Weiss D, Walker MC. Use of a maternal newborn audit and feedback system in Ontario: a collective case study. BMJ Qual Saf. 2019 Aug;28(8):635-644. doi: 10.1136/bmjqs-2018-008354. Epub 2019 Feb 16. PMID: 30772816; PMCID: PMC6663061.

Weiss D, Dunn SI, Sprague AE, Fell DB, Grimshaw JM, Darling E, Graham ID, Harrold J, Smith GN, Peterson WE, Reszel J, Lanes A, Walker MC, Taljaard M. Effect of a population-level performance dashboard intervention on maternal-newborn outcomes: an interrupted time series study. BMJ Qual Saf. 2018 Jun;27(6):425-436. doi: 10.1136/bmjqs-2017-007361. Epub 2017 Nov 24. PMID: 29175856; PMCID: PMC5965347.

Dunn S, Sprague AE, Grimshaw JM, Graham ID, Taljaard M, Fell D, Peterson WE, Darling E, Harrold J, Smith GN, Reszel J, Lanes A, Truskoski C, Wilding J, Weiss D, Walker M. A mixed methods evaluation of the maternal-newborn dashboard in Ontario: dashboard attributes, contextual factors, and facilitators and barriers to use: a study protocol. Implement Sci. 2016 May 4;11:59. doi: 10.1186/s13012-016-0427-1. PMID: 27142655; PMCID: PMC4855363.

Sprague AE, Dunn SI, Fell DB, Harrold J, Walker MC, Kelly S, Smith GN. Measuring quality in maternal-newborn care: developing a clinical dashboard. J Obstet Gynaecol Can. 2013 Jan;35(1):29-38. doi: 10.1016/s1701-2163(15)31045-8. PMID: 23343794.

Did You Know...

Audit and feedback tools—like the BORN Maternal Newborn Dashboard—can lead to measurable improvements in clinical practice. These tools are most effective when paired with education, reminders, and action planning—making them a cornerstone of quality improvement in maternal-newborn care.

Stay Informed

Are you a health-care provider interested in learning more about using the Maternal Newborn Dashboard at your organization? Contact your BORN Regional Coordinator.