1. The Maternity Quality and Safety Programme Jane Waite Christchurch Womens Hospital An overview of..

2. Maternity Quality Initiative National Quality and Safety Programme Revised Maternity Referral Guidelines Electronic Maternity Information Management Maternity Information Systems & Data Analysis

3. Building Blocks for National and Local Improvement of Maternity Services NZ Maternity Standards Primary Maternity Services Notice 2007 (Section 88) Maternity Services Specifications Referral Guidelines Maternity Clinical Indicators Maternity Clinical Guidelines

4. Implementing the Maternity Quality & Safety Programme at CDHB Governance and Leadership Information and Communication Systems Data Monitoring Coordination and Administration Sector Engagement Consumer Engagement Quality Improvement

5. Governance and Clinical Leadership – Establish a Governance Group ……………which; – Oversees maternity quality & safety activities – Ensures coherence across quality activities – Supports implementation of recommendations from national bodies – Contributes to discussions and decisions about maternity care at DHB level – Takes decisions about quality improvement activities – Produces an annual report – Includes medical and midwifery clinical leaders (community & hospital) and consumer representation

6. Information and Communication Systems Develop local communication systems for all hospital and community-based maternity clinicians. We still need Define processes for; Review of data Clinical case review Formal review for perinatal and maternal mortality and morbidity Formal review for serious and sentinel events

7. Data Monitoring Benchmarked data showing performance against NZ Maternity Clinical Indicators (CI’s). Consider o Oversight of local data collection & reporting o Agreement on data collection priorities o Ways to enhance use of data for local clinicians o How to disseminate and discuss CI’s with maternity clinicians o Quality Improvement activities arising from local CI’s

8. Coordination and Administration Manage and administer infrastructure and system requirements to achieve integrated operation of hospital and community based clinicians – FTE for medical & midwifery clinical leadership roles – FTE to administer & manage systems and infrastructure of Quality & Safety Programme – Need for midwifery liaison role as contact for LMC’s – Need for community/consumer liaison role

9. Sector Engagement Develop a coordinated local maternity network, bringing together practitioners from community and hospital settings – Defined process for linking community LMC’s with hospital-based services – Collaboratively develop engagement mechanisms with community based maternity practitioners – Develop local clinical network to include primary facility staff, rural facilities and remote LMC’s – Mechanisms for discussion and dissemination of guidelines, research, local initiatives etc…

10. Consumer Engagement Develop mechanisms to engage with maternity consumers – Inform public of services provided by community-based practitioners & hospital-based services – Develop a system to help women access community-based LMC services – Utilise maternity consumer and community groups to disseminate information to the public – Get consumer representation for DHB committees and quality & safety activities – Conduct research into maternity consumer experiences of community-based and hospital maternity services

11. Quality Improvement Broader view of matters that impact on quality and safety of maternity care Include community based midwives and GP’s in reviews and quality activities Multidisciplinary leaders will drive clinical quality improvement activity & have the ability & authority to; – Implement changes in clinical practice – Reduce unnecessary variation in clinical practice – Influence local service delivery planning & policy – Define and strengthen clinical pathways