1. Transforming Maternity Services Mini-Collaborative
July 2011
1000 Lives Plus is a five year programme to improve patient safety and reduce avoidable harm, waste and variation across NHS Wales. It will support organisations in achieving their local aims for reducing avoidable harm and mortality.
Maternity Mini-Collaborative - Aim
To improve both experience and outcomes for mothers, babies and their families within maternity services.
Learning session 2 – 7th June 11
A big thank you yet again to all of you who attended the second of our learning sessions in Cardiff. It was well attended and there was lively discussion and debate.
The day was slightly different this time with the arena handed over to you and opportunity provided for organisations to share their experiences.
Each organisation fed back their progress enabling us to identify common themes and challenges.
Thank you
Learning Session 2, June 2011
This work is based upon the ‘Transforming Care’ framework. Each Maternity Unit within Wales are at varying stages of implementing this programme.
Our Webpage
Please take time to visit our web page on
Although early days, during the coming weeks, this page will develop. Thanks for the suggestions for inclusion in the web page, these will be incorporated as far as possible. Please forward Cath any interesting links/documents etc….
‘Improvement doesn't happen without measurement’
It is important that as you commence your improvement work to start gathering bundle compliance data. The work you are undertaking could include a training programme to raise awareness of the bundles or prompts to remind people trained such as a checklist, posters. Don’t worry about initial low compliance to the bundles, this is to be expected!! Also remember this data is for you to improve for the future and not be judged upon.
What are you aiming for, a reliable process... What does this mean, 6 or more plotted data points on chart which are at 95% or above. At this level you are likely to have a positive impact on your outcome that you are aiming to improve.
Improvement doesn’t happen without measurement. You must gather and review your data regularly to decide what it is telling you and act on what you find.
Conversely measuring alone will not result in an improvement. It takes testing idea’s, developing and further testing with regular data feedback to know if you are heading in the right direction.
1000 Lives Plus, The Quality Improvement Guide – A method for Improving Public Services,
Top Tips
Recruit help from your local Improvement Team. They may be able to assist you as you implement the bundles and measure your success.
Remember that there is ongoing work in your organisation around both DVT and Sepsis – seek out the leads and where it is working well.

2. Suggestions/ideas welcome!
VTE Risk Assessment – where are we up to?
It is important that:
ALL women should be assessed at their first antenatal visit
An assessment should be undertaken at each antenatal admission
A postnatal assessment should be undertaken
There are some conditions that most clinicians seem to agree would usually lead to joint care between a specialist obstetrician and a haematologist or specialist physician and others where there is a variation in advice or practice.
Please refer to the link to our webpage in order to read the Policy Exemplar Guideline (PEG) for more information:
This practical attempt at a pragmatic approach will be monitored within the mini-collaborative as outcomes are recorded.
There now appears to be a consensus that part of the VTE risk assessment should form part of the National Hand-held Maternity Notes.
Please consider reading the information first – it should help with local policy and procedures. The collaborative may change its view as time progresses, but the important step is to undertake the assessments, that audit evidence suggests are currently being widely ignored.
Learning Session 3
Thursday 24th November 11 – Cardiff
The aim of the learning sessions are to:
Learn from faculty and colleagues
Gather new knowledge on the subject matter and process improvement
Share experiences and build collaboration on improvement plans
This is your learning session
Please forward suggestions for content/format of the day so that the time can be best utilised for YOU. Would anyone like to get involved in the organisation of this day? Thanks, Cath
There was a request in LS2 for information available to women from Public Health Wales.
Public Health Wales are currently looking at the WG general flu leaflet for this year, which will include advice to pregnant women on vaccination, symptoms, and the need to access anti-virals for flu like illness. They will also update the factsheet for midwives produced last year, which may be available as a pdf.
Do you have any comments on this? Forward to Cath 
Enhanced Support
As Programme Manager, I am now working full time hours as opposed to 3 days a week.
Please let me know how you feel I can enhance the support I provide you whilst you implement the bundles or assist you with any problems you are encountering.
Suggestions/ideas welcome!
Cath
Education & Training
One intervention within this programme focuses on training issues.
“Back to Basics” (CMACE 2011) recommends that all clinical staff must undertake regular, written, documented and audited training for the identification and initial management of serious obstetric conditions or emerging potential emergencies, such as sepsis, which need to be distinguished from commonplace symptoms in pregnancy.
Please share with Cath any training programmes you may have that address DVT Risk assessment and acutely deteriorating woman.
WebEx calls
Thursday 14th July pm
Thursday 25th August pm - Community interventions
Tuesday 6th Sept pm
Learning Session (LS) Date
Full day being held in Cardiff
LS3 Thursday 24th November 2011 (previously booked for 6th September 2011)
Dates for the diary!
SEPSIS
After the summer months and following the imminent agreement about the DVT Risk Assessment, we will be focusing on the maternity sepsis bundle. As presented at LS2, some of you are already addressing this area, so your help with this will be vital.
Programme Manager, Cath Roberts /
Faculty Lead: Mr Philip Banfield: