Supporting adoption of the pre-term birth optimisation bundle

When I joined the maternity and neonatal safety improvement programme (MatNeoSIP) eighteen months ago, I was excited to be part of a collaborative programme that would support improvements across the North West Coast.

As my background is in midwifery, I understand the pressures that services face and hope that this frontline experience helps me to support maternity units in an open and collaborative way. The enthusiasm and teamwork that maternity and neonatal unit staff have shown for implementing the MatNeoSIP has been key to the success of the programme.

One part of the MatNeoSIP is the pre-term birth optimisation bundle. This bundle of seven interventions aims to improve outcomes for infants born before 34 weeks’ gestation. The interventions are place of birth, antenatal steroids, magnesium sulphate, intrapartum antibiotics, optimal cord management, normothermia and early maternal breast milk. Nationally, 65 per cent of organisations have adopted at least four out of the seven interventions.

Late last year, we visited the maternity and neonatal teams at Liverpool Women’s Hospital as part of our regional roadshow to units across the North West Coast. Liverpool Women’s is one of the largest women’s hospital trusts in the country. The maternity unit supports over 8,000 births a year and the neonatal unit cares for more than 1,000 babies every year from Merseyside, the Isle of Man, North Wales and further afield.

Personal visits like this provide an important space for the members of the maternity and neonatal teams to share how the safety improvement programme is progressing, reflect on successes and gain support. We can do this online via Teams meetings, but relationships build so much more easily and quickly when we can meet face-to-face. What’s more, meeting like this provides an opportunity to give the team a supply of materials to promote the programme.

Our promotional pack includes posters for displaying in staff meeting areas, pens, mugs, and quick reference cards that attach to staff ID badges. These ensure the programme is visible throughout the unit, helping to keep it front of mind. I also provide a team quiz to build awareness and interest in the programme.

These creative activities are all part of quality improvement and they help me to help units to get the best results from the programme

Previously, the Patient Safety Collaboratives (PSCs), which are co-ordinated by the Innovation Agency and other AHSNs, held an in-person event to share learning across maternity and neonatal providers. The teams at Liverpool Women’s and other units value these in-person events and are keen to re-establish the meetings now we are post-pandemic.

Key to supporting local teams is our close collaboration with the North West Operational Delivery Network (NW ODN) who provide improvement data for the optimisation care bundle to all maternity trusts across the North West. This data is extracted from the neonatal Badgernet system and helps us to guide our conversations about local improvement when we are meeting teams.

Catherine Nash, Lead QI neonatal nurse for the ODN, and Dr Richa Gupta, Consultant Neonatologist, have been instrumental in developing collaborative relationships within the MatNeo SIP across maternity and neonatal teams within the North West Coast and supporting local team meetings by providing expertise from a neonatal and data perspective.

We have also collaborated with the Health Innovation Manchester MatNeo SIP team to provide quarterly special interest groups around the optimisation care bundle, enabling networking and sharing learning for teams across the North West. We receive really good feedback from clinicians at these events who value learning and sharing ideas with other units. We have also included parents and invited them to speak about their experiences of optimisation, which has given food for thought on how optimal care can be achieved and communication improved between medical professionals and parents around the time of birth.

Another way of providing support is through action learning sets and a series of these is being co-ordinated by the national patient safety improvement team and PSCs. They involve maternity and neonatal units from across the country sharing their experiences of implementing different elements of the pre-term optimisation bundle to support adoption and spread. These action learning sets are vital to enabling units to learn from each other and shorten the time to successfully adopt improvements.

Thank you to everyone who has been collaborating with me in the last year and I look forward to continuing this vital work in 2023, sharing knowledge, experiences and best practices in adopting the MatNeoSIP.

Amanda Andrews is the Innovation Agency Programme Manager for the MatNeoSIP

Follow her on Twitter: @AmandaAndrewsMW