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Female & Male Infertility Establishing Consensus-based Key Performance Indicators in Reproductive Healthcare and Fertility Nursing/Midwifery Practice Fertility Nurses & Midwives Report scroll-down-icon Introduction Assisted reproduction technology (ART), more recently referred to across Europe as medically assisted reproduction (MAR), has had a significant societal impact, resulting in over 10 million live births worldwide [1,2]. Although modern fertility case management practice varies widely across roles and regions, fertility nurses and midwives are typically the first point of contact for patients navigating the complexities of ART [3] and have the most frequent and intimate involvement in patient care [4]; therefore, they have a crucial role to play in its success. Key performance indicators (KPIs) are an objective measure that can be used to evaluate critical healthcare domains, which aim to improve patient safety and overall delivery of quality care [5,6]. Although consensus reports exist on optimising ART laboratory performance [7] and clinical practice [8], the unique and vital contributions of nurses and midwives within fertility services appear to be overlooked: there are currently no established KPIs in fertility nursing and midwifery care. Nursing KPIs are important for organisational performance: apart from improving patient care, they enable processes of transparent accountability [9]. The lack of widely accepted best practice standards and measures to evaluate the performance of nurses and midwifes in fertility care [10] makes it difficult for clinics to assess quality of care and benchmark against national standards. Integrating KPIs into fertility care, to ensure well-informed and appropriately trained fertility nurses and midwives, enhances the patient experience: integrating continuity and patient-centred care [10,11]. A national survey of fertility nurses identified a significant gap in knowledge and familiarity related to KPIs in nursing practice [10], concluding that most nurses considered it beneficial to establish a KPI consensus with recommended KPIs within their clinic [12]. Board Coordinators Caitlin Hebert Shady Grove Fertility, Washington DC, USA Biography Valerie Peddie Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, UK Biography Board Members Eleanor L. Stevenson Duke University School of Nursing Durham, North Carolina, USA Biography Helen Kendrew Independent Nurse Specialist Bath Bath, UK Biography Hilde Cotton Livio IVF Klinikken Oslo Oslo, Norway Biography Julia Gonnot Cochin Hospital Paris, France Biography Kriston Ward Strong Fertility Center Rochester, NewYork, USA Biography Louise Dias Fertility Clinic of ZAS Augustinus Augustinus, Belgium Biography Nicole Callahan MSN, APRN, CNP Mayo Clinic Rochester, Minnesota, USA Biography Patti Roberts Reproductive Science Center of the Bay Area (a USF affiliate) San Ramon, CAUSA Biography Rodriq E. Stubbs Harvard Vanguard Medical Associates Boston, Massachusetts, USA Biography Sara Somers Ghent University Hospital Ghent, Belgium Biography Sarah Lyndon Member of the ESHRE Nurses and Midwives Certification CommitteeDublin, Ireland Biography Tonie Patrick Colorado Center for Reproductive Medicine Littleton, Colorado, USA Biography Expert Panel Violet Augustus Reproductive Medicine Unit, Groote Schuur Hospital, Cape Town, South Africa Morgan Baker Utah Fertility Center, UT, USA Remi Béranger Rennes University Hospital, Rennes, France Madeleine Bernet Bern University of Applied Sciences, Bern, Switzerland Louise Boyle NHS Forth Valley, Falkirk, Scotland, UK Roxanne Buckmaster Spring Fertility, Beaverton, OR, USA Isabel Bustamante Northwell Health, New York, NY, USA Eline Dancet Faculty of Medicine, KU Leuven, Belgium Jonalyn De Vera Edades ART Fertility Clinics, Abu Dhabi, United Arab Emirates Melanie Dinis Eugin Coimbra Fertility Clinic, Coimbra, Portugal Jamie Feingold Strong Fertility Center, Rochester, NY, USA Ilkay Güngör Satılmış Istanbul University – Cerrahpaşa, Turkey Marta Hajdarevic Pacific Centre for Reproductive Medicine, Edmonton, AB, Canada Karin Hammarberg Monash University, Melbourne, VIC, Australia Anne Howard Royal College of Nursing, UK Lisa Hughes-Thompson Ghana College of Nurses and Midwives, Accra, Ghana Amber Kiddie Fertility Centers of Illinois, IL, USA Karen Henriette Kirchheiner Jensen Rigshospitalet, Copenhagen, Denmark Linda Kluge NMCC, Q-IVF, The University of Gothenburg, Sweden Vicky Loney* Aberdeen Fertility Centre, NHS Grampian, Scotland, UK Jessica Medvedich Reproductive Medicine Associates, Annandale, NJ, USA Danielle Miller San Diego Fertility Center, San Diego, CA, USA Darshana Naik Shady Grove Fertility, Walter Reed Medical Center, Bethesda, MD, USA Hetty Ockhuijsen Utrecht University Medical Centre, Utrecht, The Netherlands Malgorzata Piatkowska Invimed Clinic, Warsaw Mokotów, Poland Melissa Pichi Reproductive Medicine Associates, New York, NY, USA Katherine Pleace School of Nursing, Psychotherapy and Community Health, University of Essex, UK Shana Puetz Tennessee Fertility Institute, TN, USA Leigh Anne Reid* Aberdeen Fertility Centre, NHS Scotland, UK Elisa Rinta-Lusa HUS, Helsinki, Finland Fernanda Robin Ser Fertilidade Ltda, Brazil Courtney Schmidt Shady Grove Fertility, Richmond, VA, USA Britt Schoonjans Brussels IVF, University Hospital Brussels, Belgium Carole Tilbrook Repromed, Adelaide, SA, Australia Jen Ulyatt NHS Tayside, Dundee, Scotland, UK Chloë Van Loock UZ Leuven, Leuven, Belgium Maureen Wood NHS Tayside, Dundee, Scotland, UK Jennifer Wood Shady Grove Fertility, Washington, DC, USA world map showing the geographic distribution of respondents The concept of “advanced practice” in nursing and midwifery The term “midwifery” in this study is used broadly to describe the role of advanced nursing practice. Globally, providers hold different educational backgrounds and professional titles; nevertheless, their role is similar: they are trained to provide autonomy of practice, including leadership, medical diagnosis, treatment, research and education within their area of specialist practice. In the United States, common titles include Nurse Practitioner (NP), Physician Assistant (PA/Physician Associate), and Certified Nurse-Midwife (CNM). Collectively, these roles are often referred to as Advanced Practice Providers (APPs). In the United Kingdom, the pathway to becoming a registered midwife previously required completion of 3 years of college-based training and registration in general nursing, followed by 18 months of college-based midwifery training, but now allows for direct entry, and requires completion of a midwifery degree (3 years). All qualifications must be approved by the Nursing and Midwifery Council (NMC). For a midwifery degree obtained within EU/EEA states, students must complete a 3-year university-based course. “Advanced practice” in the UK is defined by the level of practice, rather than reflecting a job title. Although several definitions of advanced practice exist globally, in the UK it is underpinned by a master’s level of study and four pillars of practice, characterised by clinical management, leadership, education and