Implementation and evaluation of a quality improvement initiative to reduce late gestation stillbirths in Australia: Saf
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(2020) 20:694
STUDY PROTOCOL
Open Access
Implementation and evaluation of a quality improvement initiative to reduce late gestation stillbirths in Australia: Safer Baby Bundle study protocol C. J. Andrews1, D. Ellwood1,2, P. F. Middleton1,3, A. Gordon1,4, M. Nicholl5, C. S. E. Homer6, J. Morris5, G. Gardener1, M. Coory1, M. Davies-Tuck1,7, F. M. Boyle1,8, E. Callander9, A. Bauman4, V. J. Flenady1* and on behalf of the Safer Baby Bundle collaborators
Abstract Background: In 2015, the stillbirth rate after 28 weeks (late gestation) in Australia was 35% higher than countries with the lowest rates globally. Reductions in late gestation stillbirth rates have steadily improved in Australia. However, to amplify and sustain reductions, more needs to be done to reduce practice variation and address suboptimal care. Implementing bundles for maternity care improvement in the UK have been associated with a 20% reduction in stillbirth rates. A similar approach is underway in Australia; the Safer Baby Bundle (SBB) with five elements: 1) supporting women to stop smoking in pregnancy, 2) improving detection and management of fetal growth restriction, 3) raising awareness and improving care for women with decreased fetal movements, 4) improving awareness of maternal safe going-to-sleep position in late pregnancy, 5) improving decision making about the timing of birth for women with risk factors for stillbirth. Methods: This is a mixed-methods study of maternity services across three Australian states; Queensland, Victoria and New South Wales. The study includes evaluation of ‘targeted’ implementer sites (combined total approximately 113,000 births annually, 50% of births in these states) and monitoring of key outcomes state-wide across all maternity services. Progressive implementation over 2.5 years, managed by state Departments of Health, commenced from mid-2019. This study will determine the impact of implementing the SBB on maternity services and perinatal outcomes, specifically for reducing late gestation stillbirth. Comprehensive process, impact, and outcome evaluations will be conducted using routinely collected perinatal data, pre- and post- implementation surveys, clinical audits, focus group discussions and interviews. Evaluations explore the views and experiences of clinicians embedding the SBB into routine practice as well as women’s experience with care and the acceptability of the initiative. (Continued on next page)
* Correspondence: [email protected] 1 Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Mater Health Services, Level 3 Aubigny Place, South Brisbane, QLD 4101, Australia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, prov
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