Unwarranted variation in maternity care can cause issues including introducing risks to patient safety, sub-optimal clinical practice and complications for staff who regularly rotate between different units. All this can adversely affect patient care and safety.
Over the past two years the Oxford AHSN Maternity Clinical Network has developed, agreed and implemented sets of clinical guidelines which optimise care across the Oxford AHSN region. Consistency of care and aligning guidelines mitigates potential patient safety issues, especially when women can be seen in more than one hospital during their pregnancy.
Each guideline has been designed around a simple algorithm that fits onto a single side of paper which can be incorporated into existing guidelines as an appendix. The content of these guidelines was written by Network members based on best available evidence and current national guidance. The Steering Group (which has clinical and midwifery representation from all member trusts) was given the opportunity to comment and amend all guidelines during a three-month consultation period.
Building on this initial set, stakeholders put forward suggestions for further guideline alignment. With this and local needs in mind, a new set of guidelines was chosen. These guidelines are now embedded in, or in the process of being embedded in, each Trust in the region.
Ratified and agreed guidelines
The current agreed and ratified network-wide guidelines are:
- Pregnancies complicated with red cell antibodies other than anti c, anti d and anti K Guideline, V1
- Pregnancies complicated with anti c, anti d and anti k alloimmunisation Guideline, V1
Extreme preterm bundle:
Intrauterine growth restriction (IUGR)
Improving the use of placental histology
Perinatal Palliative Care Framework
Guidelines in development
The Maternity Clinical Network Steering Group has agreed to tackle the following across the Oxford AHSN region in 2016/17:
- Reducing variation in oxytocin (syntocinon) protocols for the augmentation of labour
- Reducing variation and improving cardiotocograph (CTG) interpretation
- A Reduced Fetal Movement Audit (RFM) is currently underway to identify areas for improvement when dealing with women reporting RFM