Promoting normal birth within the multidisciplinary team

Topic area: Evaluating the ‘Focus on normal birth and reducing caesarean section rates Rapid Improvement Programme’
Description of innovation:
The NHS Institute for Innovation and Improvement initiated Rapid Improvement Programmes in sixteen high volume areas of healthcare where significant variation in clinical practice existed in England; caesarean section was one of the areas included.
The objectives of the Spread and Adopt Rapid Improvement Programme were to:
• Promote normal birth and reduce caesarean section rates
• Promote the importance of the impact of maternity unit culture on caesarean rates
• Encourage multidisciplinary working
• Provide training in service improvement tools.
The Rapid Improvement Programme include the following components:
• A self-improvement toolkit and CD Rom
• Facilitation of maternity teams in their local setting by clinically-experienced maternity professionals and a self-improvement associate
• Events for Early Adopter maternity teams facilitated by NHS Institute Teams at their base
• Three network events held in each SHA in England and open to all maternity units
Following a process of application and selection, twenty ‘Early Adopter’ NHS Trusts participated during 2008-2009. An independent evaluation, commissioned by the NHS Institute for Innovation and Improvement, utilised a mixed-methods approach to determine impacts against the programme’s four objectives from the perspectives of teams in Early Adopter Trusts. These teams included maternity staff and service user representatives. The evaluation included three phases: collection and analysis of existing data; collection and analysis of mode of birth data; collection and analysis of new data using web-based questionnaires and semi-structured telephone interviews.
This presentation will focus on findings from data collected using semi-structured, telephone interviews. Following full transcription, data were analysed using Nvivo software. Respondents were based in six Early Adopter Trusts with varying rates of caesarean section and included maternity professionals and service user representatives.
Discussion: Themes identified in the data including the role of teamwork across disciplinary groups, the involvement of service user representatives, the importance of project champions and achieving sustainability will be discussed.
Conclusion: Recommendations will be made for similar programmes and service improvement activities related to promoting normal birth.