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The journey -

This year-long programme looked at caesarean rates across the NHS south central region in order to identify reasons for variation in practice.  The programme team worked directly with five maternity units whose caesarean section rates were below a benchmarked norm.  In each case they undertook an in-depth investigation into why they were performing particularly well.  These investigations were presented as case studies on best practice and shared with all participating trusts at networking events. Alongside the case study investigations, the team developed a regional normal birth pathway.  

Outcomes

All the units in the programme were able to work on areas of improvement in practice and by the end of the programme everyone was able to share examples of specific improvements.  The process of identifying and sharing best practice reduced variation and raised standards across the region.  A final report summarised the learning from the programme. As well as driving up clinical standards, the team also noted a maturing of attitudes and behaviours as a result of the programme.    

Patient setting

In-patient   X Out-patient Community based
Mental health Chronic illness Cross-systems
 

Clinical area

Staying healthy Maternity and newborn   X Children and young people Acute care
Planned care   X Mental health Long-term conditions End of life
 

Information, tools and techniques used

The programme used an appreciative inquiry approach, focussing on best practice.  It was led by a clinical director.  

Geography

The programme covered maternity units in the NHS South Central region.  

Timescale

This was a year-long programme which took place in 2010 – 2011.

Contact details and further information

Nicky Mason, Midwife Consultant: nicky.mason@institute.nhs.uk [post_title] => Sharing best practice in reducing caesarean rates [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => sharing-best-practice-in-reducing-caesarean-rates [to_ping] => [pinged] => [post_modified] => 2013-01-16 15:25:05 [post_modified_gmt] => 2013-01-16 15:25:05 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3413 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 3412 [post_author] => 8 [post_date] => 2013-01-16 15:21:54 [post_date_gmt] => 2013-01-16 15:21:54 [post_content] =>

The journey -

The aim of the Normalising Birth programme was to address the clinical variation in deliveries across the 11 acute trusts in the South East Coast region. It was important in the early stages to develop a clear understanding of why the variation in birth intervention (primarily Caesarean sections) existed, and to identify those units who were performing well. From here, best practice could be spread. Care providers have been pressurised to respond to data on Caesarean rates by lowering them, however, this data was regarded by the project manager as a somewhat blunt indicator of the quality of maternity care. The vision was to explore this clinical variation in more meaningful ‘sub-groups’. A detailed exploration was seen as a potentially powerful tool for initiating change and improvement across the region.  

Outcomes

A significant achievement of the programme is a unique dataset which now exists, illustrating the regional clinical variation in intervention, at a more meaningful level of detail. Trusts are now able to look at their own performance in direct comparison to that of other trusts, something which has provided additional clarity in analysing their own performance and working culture. The development and use of this data has been instrumental in helping trusts to learn collaboratively and share best practice, for example in supporting or advising other units facing similar challenges. A further achievement has been the increase in enthusiasm for new, larger projects arising from the collaborative nature of the programme and resulting increase in confidence created through the group process.  

Patient setting

In-patient   X Out-patient Community based
Mental health Chronic illness Cross-systems
 

Clinical area

Staying healthy Maternity and newborn X Children and young people Acute care
Planned care   X Mental health Long-term conditions End of life
 

Information, tools and techniques used

No specific change model was followed, although elements of the PDSA (Plan, Do, Study, Act) cycle were used.   Clinical network meetings were facilitated by staff from NHSI specialising in the maternity pathway. The clinical group also provided invaluable peer support for each other, sharing tested methodologies in the process.  

Geography

All acute trusts in the South East Coast area (Kent, Surrey and Sussex) were involved.

 

Timescale

The project ran from April 2010 until March 2012, when funding came to an end.  Information is still added to the programme’s database however, and this continues to be analysed.  

Contact details and further information

Normalising Birth was led by Tony Kelly tony.kelly@bsuh.nhs.uk

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The journey -

This year-long programme looked at caesarean rates across the NHS south central region in order to identify reasons for variation in practice.  The programme team worked directly with five maternity units whose caesarean section rates were below a benchmarked norm.  In each case they undertook an in-depth investigation into why they were performing particularly well.  These investigations were presented as case studies on best practice and shared with all participating trusts at networking events. Alongside the case study investigations, the team developed a regional normal birth pathway.  

Outcomes

All the units in the programme were able to work on areas of improvement in practice and by the end of the programme everyone was able to share examples of specific improvements.  The process of identifying and sharing best practice reduced variation and raised standards across the region.  A final report summarised the learning from the programme. As well as driving up clinical standards, the team also noted a maturing of attitudes and behaviours as a result of the programme.    

Patient setting

In-patient   X Out-patient Community based
Mental health Chronic illness Cross-systems
 

Clinical area

Staying healthy Maternity and newborn   X Children and young people Acute care
Planned care   X Mental health Long-term conditions End of life
 

Information, tools and techniques used

The programme used an appreciative inquiry approach, focussing on best practice.  It was led by a clinical director.  

Geography

The programme covered maternity units in the NHS South Central region.  

Timescale

This was a year-long programme which took place in 2010 – 2011.

Contact details and further information

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Tag: Caesarean

Sharing best practice in reducing caesarean rates

The journey – This year-long programme looked at caesarean rates across the NHS south central region in order to identify reasons for variation in practice.  The programme team worked directly with five maternity units whose caesarean section rates were below a benchmarked norm.  In each case they undertook an in-depth investigation into why they were […]

Posted on Jan 16th Cat: , , , Tags: Comments: Comments are off for this post

Normalising Birth programme

The journey – The aim of the Normalising Birth programme was to address the clinical variation in deliveries across the 11 acute trusts in the South East Coast region. It was important in the early stages to develop a clear understanding of why the variation in birth intervention (primarily Caesarean sections) existed, and to identify […]

Posted on Jan 16th Cat: , , , Tags: Comments: Comments are off for this post