Enhanced quality improvement (QI) programmes may be necessary to support the adoption of best practice in maternity units with less developed integrated working practices, a new paper published in the Journal Implementation Science suggests. The research builds on ARC West’s evaluation of the AHSN Network’s national PReCePT programme, led by the West of England AHSN, and the conduct of the nested PReCePT study.

Magnesium sulphate is a low-cost medicine given to women going into early labour to protect their babies’ brains. It reduces the risk of cerebral palsy by a third.

The national PReCePT programme supported maternity units in England to increase their use of magnesium sulphate for women in early labour. The programme aimed to increase use of magnesium sulphate by 2020 to 85% of eligible mothers, with a stretch target of 95% for high-performing units.

The paper compares the implementation outcomes from scaling up the PReCePT programme with either the standard QI package or an enhanced package, tested via the PReCePT study.

The researchers found that all units, irrespective of whether they received a standard or enhanced QI package, succeeded in restructuring their ways of working to enable them to administer magnesium sulphate.

However, sustaining the changes once resources such as the support offered through the PReCePT programme had been withdrawn, required additional implementation work.

The findings suggest that to sustain the benefits from such programmes, ‘relational restructuring’ was needed. This means that doctors and midwives had to work and communicate as a team and support each other to accommodate new workflows and facilitate the sharing of responsibilities and tasks in daily practice.

Relational restructuring was more likely to have been achieved in units receiving enhanced QI support but also happened in units with standard QI support, especially in those where perinatal team working was already well established.

These findings emphasise the importance of working beyond siloes and across teams in maternity units, chiming with the findings of the Ockenden report. Enhanced QI initiatives, modelled on PReCePT, could be one way of improving teamwork in maternity units where more multidisciplinary working is needed.

Karen Luyt, Professor of Neonatal Medicine at the University of Bristol and PReCePT clinical lead, said:

“In this large national qualitative study we identified that collaborative multi-professional / perinatal team working is the key factor in implementing and sustaining new maternity treatments to protect babies.

“The PReCePT enhanced QI model was effective in supporting multi-professional teams, challenged by division/weak collaboration, to sustain improved care. These findings are widely applicable to maternity units invested in improving outcomes for mothers and babies, providing an evidence base for future programmes bringing new treatments into routine clinical practice.”

Posted on June 28, 2023

> Back to index

  twitter   facebook   linkedin

Events you may like

Brave Spaces: workshops for perinatal staff who identify as Black or mixed Black

Do you work in the South West or West of England within maternity, obstetrics, neonatology or other NHS community services supporting pregnancy and …

Tuesday 16 July 2024, 9:30-12:30pm
Location: Sakura Bristol Studio’s, Unit 2 White Street, Saint Jude's, Bristol BS5 0TS
Organised by: Health Innovation West of England

Read & book

Regional Perinatal Equity Network

Health Innovation South West and Health Innovation West of England, in partnership with the Regional Maternity and Perinatal team, invite you to join …

Wednesday 11 September 2024, 10:00am - 12:00pm
Location: Online - MS Teams
Organised by: Health Innovation South West and Health Innovation West of England

Read & book

News you may like

Black Maternity Matters statement: APPG on birth trauma inquiry report

The Black Maternity Matters collaborative welcomes the report released by the APPG on Birth Trauma sharing the findings of its inquiry. We honour and thank the women and families who have shared their traumatic experiences at psychological cost to their wellbeing, in order to make significant change to the way perinatal care is provided through…

Read more

House of Lords Preterm Birth Committee hear evidence on impact of PERIPrem

The operational clinical lead for the PERIPrem programme, Dr Sarah Bates, has given evidence alongside a panel including Professor David Edwards, Professor of Paediatrics & Neonatal Medicine at Kings College London and Professor Chris Gale, Professor of Neonatal Medicine at Imperial College London, to the House of Lords Preterm Birth Committee. The Committee was appointed…

Read more

PreCiSSIon announced as finalist in the 2024 HSJ Partnership Awards

We have been shortlisted in the ‘Most Impactful Partnership in Preventative Healthcare’ category at the 2024 HSJ Partnership Awards for our work with Cemplicity and healthcare professionals to reduce the impact of surgical site infections (SSI) following caesarean birth. The PreCiSSIon (Preventing Caesarean Birth Surgical Site Infection across a region) project focussed on work with…

Read more