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However, sustaining the changes once resources such as the support offered through the PReCePT programme had been withdrawn, required additional implementation work.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
Events you may like
Maternity and Neonatal Safety Improvement Programme: Breaking down barriers for safer systems
This free, in person event is suitable for all members of perinatal teams and includes a complimentary lunch. Don’t miss this fantastic opportunity to …
Date(s):
Wednesday 30 April 2025, 9:30am - 3:30pm
Location: The Bristol Pavilion, Nevil Rd, Bishopston, Bristol BS7 9EJ
Organised by: Health Innovation West of England
Maternity and neonatal deterioration share and learn event
Join Health Innovation West of England, South West, and Wessex for an engaging Maternity and neonatal deterioration share and learn event on Thursday …
Date(s):
Thursday 15 May 2025, 10am -12pm
Location: Online - MS Teams
Organised by: Health Innovation South West, Health Innovation Wessex and Health Innovation West of England
News you may like
“Deeply affirming” – Black Maternity Matters collaborative celebrates winning national award
Members of the Black Maternity Matters collaborative are celebrating after scooping the award for ‘Community Project Impact’ at the prestigious Black Maternal Health Awards UK 2025. Held in London on Saturday 22 March to celebrate excellence across maternal healthcare, The Black Maternal Health Awards were hosted by The Motherhood Group. Black women in the UK remain…
Read more
PreCiSSIon shortlisted for Prestigious HSJ Digital Awards 2025
Our PreCiSSIon (Preventing Caesarean Birth Surgical Site Infection across a region) project has been shortlisted in the category of ‘Driving Change through Data and Analytics’ HSJ Digital Awards 2025 for our work with Cemplicity and the maternity units across the West of England to reduce the impact of surgical site infections (SSI) following caesarean birth. This year marks a milestone for…
Read more
Black Maternity Matters shortlisted for national award
The Black Maternity Matters collaborative has made it to the finals of the prestigious Black Maternal Health Awards UK. We’ve been shortlisted in the Community Project category, which celebrates initiatives creating measurable change in maternal health outcomes at a local level. The Black Maternal Health Awards UK, spearheaded by The Motherhood Group, celebrate excellence across…
Read more
