Blog

This year’s World Patient Safety Day on Friday 17 September 2021 is focusing on safe and respectful childbirth. The World Health Organisation is highlighting how the majority of poor outcomes are avoidable through the provision of safe and quality care by skilled health professionals working in supportive environments.

Our Patient Safety Collaborative (PSC) is delivered by the Improvement Academy as part of the Bradford Institute for Health Research. It has five priority areas, including maternity and neonatal (MatNeoSIP). Jackie Hallam is our MatNeo workstream lead for the PSC and here she talks about how we’re working with maternity teams across the region to provide better care for mothers and their babies. 

In Yorkshire and Humber, the Patient Safety Collaborative has been working with our maternity and neonatal teams since 2017, supporting a wide range of safety initiatives and improving care across the region for pregnant women, babies and families that resonate with the aims of today’s theme.

The Maternity and Neonatal Safety Improvement Programme (MatNeoSIP) is one of the work streams within the wider National Patient Safety Improvement Programme led by NHS England and Improvement and the AHSN Network.

Of course, as with all programmes of work across all sectors, COVID-19 put the brakes on our projects as it became all hands-on deck to tackle the pandemic. However, having engagement from all 13 Trusts in the Yorkshire and Humber region has really helped us to develop specific quality improvement projects concentrating on three main work streams, all of which aim:

“To reduce the national rate of pre-term births from 8% to 6% and reduce the rate of stillbirths, neonatal death and brain injuries occurring during or soon after birth by 50% by 2025.”

This work also links well to one of the aims for World Patient Safety Day: ‘Engage multiple stakeholders and adopt effective and innovative strategies to improve maternal and new-born safety’.

It is something we are particularly proud of in Yorkshire and Humber, having a long history of working together with clinical colleagues, health care research teams and families to develop innovative ideas to improve care.

There are three main work streams within MatNeoSIP. They are:

1. Improving smoke-free pregnancies: We are working with colleagues at Public Health England to take a regional approach to tackle the high prevalence of smoking during pregnancy rates in Yorkshire and Humber.  There is already an enormous amount of work being done in this area within our three Local Maternity Systems in line with ‘Saving Babies Lives’ and we’ve been measuring its improvement.
2. Early recognition and management of deterioration of women and babies: The need to standardise Early Warning Score observation charts in maternity and neonatal care has been recognised for some time.  The national Maternity Neonatal Safety Improvement Programme is taking the reins on making this happen. We are looking forward to supporting the regional roll out of new charts, the development of which was supported by our colleagues at Hull University Teaching Hospitals.
3. Optimisation and stabilisation of the preterm infant: For several years, in conjunction with colleagues in our Maternity Clinical Network and Neonatal Operational Delivery Network, we’ve focused on making sure that babies are born in the safest place for their gestation.  We’ve are continuing our work with colleagues in Trusts and in the clinical networks to understand and tackle some of the barriers to safe practice and improve the outcomes for preterm babies.

All this improvement work is underpinned by eight key enablers intended to encompass the wider population health challenges.

• Addressing inequalities – tackling the issue around unequal access to care which has been exacerbated by COVID-19 is going to be a key focus for our programme.
• Patient and carer co-design – Ensuring the service-user voice is not only heard but actually listened to and acted upon is vital to improving safer care. We have strengthened our relationships with Maternity Voice Partnership colleagues across the region to fulfil this fundamental requirement.
• Safety culture – A positive team safety culture is the basis for safe and reliable care; it weaves into everything we do, everything we work towards and influences all aspects of communication. During Phase 1 of the programme all units undertook a Safety Culture survey.  We worked with Trusts to debrief results and provided guidance to implement action plans to improve safety culture within teams. We are now well equipped to advise and support teams to improve culture and nurture an environment that is psychologically safe for everyone.
• Patient Safety Network – We host four regional network meetings each year and it is how we work together with maternity and neonatal colleagues across the area to share learning, good practice, and challenges to develop, improve and move forward.
• Improvement Leadership – The benefits of effective leadership and influencing change cannot be underestimated. We have designed a Maternal and Neonatal Quality Improvement Coaching package for clinical leaders to support them with improvement projects to achieve sustained change in practice.
• Building QI capacity and capability – The Yorkshire & Humber Improvement Academy provides an online Quality Improvement (QI) package to introduce the basics of QI methodology. This is free and open access to anyone.
• Measurement – This is fundamental to all improvement projects and the key indicator to show that interventions are making a difference. For example, the MEaCC (Maternal Enhanced and Critical Care ) project looks at audit data to better understand critical care in maternity settings and will use this insight to establish the skills and competencies a nurse or midwife should have when caring for a woman with enhanced or critical care needs.
• Improvement and innovation pipeline – Horizon scanning is continually on our radar. We always have our ears to the ground picking up new innovative practice and sharing it through the Patient Safety Network for the benefit of all.

There is still a lot of work to do within the Maternity and Neonatal Safety Improvement Programme and we, as a team, remain motivated and eager to evolve and improve for the benefit of the service-users, their families, and staff in our region.

If you would like to get involved in any of our networks or projects or want any further information, please email: Jacqueline.hallam@yhia.nhs.uk or Shireen.ridley@yhia.nhs.uk