BMJ Open Quality最新文献

{"title":"Use of computer simulation to identify effects on hospital census with reduction of transfers for non-procedural patients in community hospitals.","authors":"Laura Walker, Katharina Kohler, Matthew Jankowski, Todd Huschka","doi":"10.1136/bmjoq-2023-002652","DOIUrl":"10.1136/bmjoq-2023-002652","url":null,"abstract":"<p><strong>Objective: </strong>In-person healthcare delivery is rapidly changing with a shifting employment landscape and technological advances. Opportunities to care for patients in more efficient ways include leveraging technology and focusing on caring for patients in the right place at the right time. We aim to use computer modelling to understand the impact of interventions, such as virtual consultation, on hospital census for referring and referral centres if non-procedural patients are cared for locally rather than transferred.</p><p><strong>Patients and methods: </strong>We created computer modelling based on 25 138 hospital transfers between June 2019 and June 2022 with patients originating at one of 17 community-based hospitals and a regional or academic referral centre receiving them. We identified patients that likely could have been cared for at a community facility, with attention to hospital internal medicine and cardiology patients. The model was run for 33 500 days.</p><p><strong>Results: </strong>Approximately 121 beds/day were occupied by transferred patients at the academic centre, and on average, approximately 17 beds/day were used for hospital internal medicine and nine beds/day for non-procedural cardiology patients. Typical census for all internal medicine beds is approximately 175 and for cardiology is approximately 70.</p><p><strong>Conclusion: </strong>Deferring transfers for patients in favour of local hospitalisation would increase the availability of beds for complex care at the referral centre. Potential downstream effects also include increased patient satisfaction due to proximity to home and viability of the local hospital system/economy, and decreased resource utilisation for transfer systems.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11202728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving quality of care by standardising patient data collection in electronic medical records in an oncology department in Spain.","authors":"Guillermo Alonso-Jáudenes Curbera, Martín Igor Gómez-Randulfe Rodríguez, Beatriz Alonso de Castro, Sofía Silva Díaz, Iria Parajó Vázquez, Paula Gratal, Rafael López López, Rosario García Campelo","doi":"10.1136/bmjoq-2023-002732","DOIUrl":"10.1136/bmjoq-2023-002732","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of quality of care in oncology is key in ensuring patients receive adequate treatment. American Society of Clinical Oncology's (ASCO) Quality Oncology Practice Initiative (QOPI) Certification Program (QCP) is an international initiative that evaluates quality of care in outpatient oncology practices.</p><p><strong>Methods: </strong>We retrospectively reviewed free-text electronic medical records from patients with breast cancer (BR), colorectal cancer (CRC) or non-small cell lung cancer (NSCLC). In a baseline measurement, high scores were obtained for the nine disease-specific measures of QCP Track (2021 version had 26 measures); thus, they were not further analysed. We evaluated two sets of measures: the remaining 17 QCP Track measures, as well as these plus other 17 measures selected by us (combined measures). Review of data from 58 patients (26 BR; 18 CRC; 14 NSCLC) seen in June 2021 revealed low overall quality scores (OQS)-below ASCO's 75% threshold-for QCP Track measures (46%) and combined measures (58%). We developed a plan to improve OQS and monitored the impact of the intervention by abstracting data at subsequent time points.</p><p><strong>Results: </strong>We evaluated potential causes for the low OQS and developed a plan to improve it over time by educating oncologists at our hospital on the importance of improving collection of measures and highlighting the goal of applying for QOPI certification. We conducted seven plan-do-study-act cycles and evaluated the scores at seven subsequent data abstraction time points from November 2021 to December 2022, reviewing 404 patients (199 BR; 114 CRC; 91 NSCLC). All measures were improved. Four months after the intervention, OQS surpassed the quality threshold and was maintained for 10 months until the end of the study (range, 78-87% for QCP Track measures; 78-86% for combined measures).</p><p><strong>Conclusions: </strong>We developed an easy-to-implement intervention that achieved a fast improvement in OQS, enabling our Medical Oncology Department to aim for QOPI certification.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of coproduction in the sustainability of innovations in applied health and social care research: a scoping review.","authors":"Charlotte Overton, Carolyn Tarrant, Jennifer Creese, Natalie Armstrong","doi":"10.1136/bmjoq-2024-002796","DOIUrl":"10.1136/bmjoq-2024-002796","url":null,"abstract":"<p><strong>Background: </strong>Innovations such as toolkits and frameworks are developed through applied health and social care research, to address identified gaps in quality or safety of care. The intention is to subsequently implement these innovations into practice to bring about improvements. Challenges can arise from poor choice of implementation strategies or lack of alignment to local contexts. Research has identified the importance of involving and engaging patients, health professionals and other stakeholders in the design and delivery of the underpinning research, and in informing subsequent implementation. However, how and why such coproduction influences the sustainability of innovations in health and social care is unclear.</p><p><strong>Objective: </strong>The objective of this scoping review is to identify and present the available evidence regarding the role of coproduction in the sustainability of innovations in applied health and social care research.</p><p><strong>Inclusion criteria: </strong>This scoping review includes papers related to the role of coproduction in the sustainability of innovations in applied health and social care research published in peer-reviewed journals. The review is limited to articles reporting applied health and social care research conducted in the United Kingdom.</p><p><strong>Methods: </strong>Scopus, Web of Science, CINAHL and MEDLINE were searched for studies. Titles and abstracts were screened by two independent reviewers for assessment against the inclusion criteria, followed by a full-text review and data extraction. Data were extracted using a data extraction form developed by the reviewers. The completed forms were imported into NVivo and analysed using basic qualitative content analysis.</p><p><strong>Results: </strong>Our review provides insight into the role of coproduction in the sustainability of innovations in applied health and social care research. Our findings highlight that sustainability is a dynamic process, supported by coproduction activities such as ongoing collaborative partnerships; these can be planned for in both the research design and implementation phases of a project.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141417616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary uses of electronic prescribing and pharmacy data in UK hospital care: a national survey.","authors":"Navila Talib Chaudhry, Jonathan Benn, Bryony Dean Franklin","doi":"10.1136/bmjoq-2024-002754","DOIUrl":"10.1136/bmjoq-2024-002754","url":null,"abstract":"<p><p>Electronic hospital pharmacy (EHP) systems are ubiquitous in today's hospitals, with many also implementing electronic prescribing (EP) systems; both contain a potential wealth of medication-related data to support quality improvement. The reasons for reuse and users of this data are generally unknown. Our objectives were to survey secondary use of data (SUD) from EHP and EP systems in UK hospitals, to identify users of and factors influencing SUD.A national postal survey was sent out to all hospital chief pharmacists with pre-notifications and follow-up reminders. Descriptive statistical analysis was performed.Of 187 hospital organisations, 65 (35%) responded. All had EHP systems (for ≥20 years) and all reused data; 50 (77%) had EP systems (established 1-10 years) but only 40 (80%) reused data. Reported facilitators for SUD included medication safety, providing feedback, benchmarking, saving time and patient experience. The purposes of SUD included audits, quality improvement, risk management and general medication-related reporting. Earlier introduction of SUD could provide an opportunity to heighten local improvement initiatives.Data from EHP systems is reused for multiple purposes. Evaluating SUD and sharing experiences could provide richer insight into potential SUD and barriers/factors to consider when implementing or upgrading EP/EHP systems.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141417617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality improvement initiative 'S-A-F-H' to reduce healthcare-associated neonatal sepsis in a tertiary neonatal care unit.","authors":"Aditya Kallimath, Suprabha K Patnaik, Nandini Malshe, Pradeep Suryawanshi, Pari Singh, Reema Gareghat, Vinaya Nimbre, Kalyani Ranbishe, Archana Gautam Kamble, Vishwas Ambekar","doi":"10.1136/bmjoq-2023-002336","DOIUrl":"10.1136/bmjoq-2023-002336","url":null,"abstract":"<p><strong>Background: </strong>Neonatal sepsis is a leading cause of morbidity and mortality among admitted neonates. Healthcare-associated infection (HAI) is a significant contributor in this cohort.</p><p><strong>Local problem: </strong>In our unit, 16.1% of the admissions developed sepsis during their stay in the unit.</p><p><strong>Method: </strong>We formed a team of all stakeholders to address the issue. The problem was analysed using various tools, and the main contributing factor was low compliance with hand hygiene and handling of intravenous lines.</p><p><strong>Interventions: </strong>The scrub the hub/aseptic non-touch technique/five moments of hand hygiene/hand hygiene (S-A-F-H) protocol was formulated as a quality improvement initiative, and various interventions were done to ensure compliance with hand hygiene, five moments of hand hygiene, aseptic non-touch technique. The data were collected and analysed regularly with the team members, and actions were planned accordingly.</p><p><strong>Results: </strong>Over a few months, the team could reduce the incidence of HAI by 50%, which has been sustained for over a year. The improvement in compliance with the various aspects of S-A-F-H increased.</p><p><strong>Conclusions: </strong>Compliance with hand hygiene steps, five moments of hand hygiene and an aseptic non-touch technique using quality improvement methodology led to a reduction in neonatal sepsis incidence in the unit. Regular reinforcement is required to maintain awareness of asepsis practices and implementation in day-to-day care and to bring about behavioural changes.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141417615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early provision of clinical information with an 'opt in' approach improves patient experience in tonsillectomy referrals.","authors":"Nichola Philp, Raeesah Maqsood, Adithya Joshyulla-Prasanna, Robert Bauke van der Meer, Catriona M Douglas, Margaret Wood, Lech Rymaszewski","doi":"10.1136/bmjoq-2024-002772","DOIUrl":"10.1136/bmjoq-2024-002772","url":null,"abstract":"<p><p>Patients referred by their general practitioner (GP) with a definite diagnosis, for example, recurrent sore throat for consideration of tonsillectomy in adults, may wait for months without receiving any further clinical information from the hospital until their outpatient consultation. Prompt provision of condition-specific information after referral has received little attention despite considerable potential to enhance patients' understanding, thereby relieving uncertainty and anxiety, and facilitating shared decision-making.This study aimed to report the experience of patients with recurrent tonsillitis who had been sent a booklet outlining the benefits and risks of tonsillectomy immediately after GP referral.Greater Glasgow and Clyde Health Board received 218 referrals of patients aged 16-40 to discuss tonsillectomy between January and August 2022. Every patient was sent a 16-page booklet by post and given the choice to opt in for a consultation.165 (76%) patients opted in, and 53 (24%) did not. Feedback was obtained from 143 patients (66%) from both groups. 99% found the information booklet easy to understand, 97% would recommend it to a friend with recurrent tonsillitis, 93% felt their questions had been answered and 92% believed it helped them to decide whether to proceed with tonsillectomy. Socioeconomic deprivation did not influence the outcome.In conclusion, most patients found provision of clinical information immediately after vetting of the referral to be beneficial, irrespective of whether they opted in for a consultation. This concept has broad applicability across all specialties, and the principles can be readily adopted and adapted by clinicians and managers in local units.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11177666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality improvement initiative to standardise the anthropometric assessment for children under the age of 5 years at an urban primary health centre in New Delhi.","authors":"Adhish Kumar Sethi, Sumna Velarambath Manalil, Sandeep Das, Shahana Singh, Roshan Mariam Manu, Riya Biswas, Pranav Shankar, Parshav Gilhotra, Ravneet Kaur, Baridalyne Nongkynrih","doi":"10.1136/bmjoq-2023-002583","DOIUrl":"10.1136/bmjoq-2023-002583","url":null,"abstract":"<p><strong>Background: </strong>Anthropometric assessment in the paediatric population is particularly important to assess the child's general health status, nutritional adequacy, and growth and developmental pattern. However, there are often shortcomings in the quality of anthropometric assessment done in primary healthcare settings despite the presence of established guidelines. In this study, we plan to use the quality improvement (QI) principles to improve the anthropometric assessment of under-5 children attending an urban primary health centre in Delhi, India.</p><p><strong>Methods: </strong>The study was conducted from December 2022 to February 2023. A baseline assessment was conducted to identify the gaps in the anthropometric measurement of under-5 children visiting the outpatient department. A QI team consisting of doctors and key health staff of urban health centre as its members was formed. A root cause analysis of the identified problems was done and changes were planned and implemented in a Plan-Do-Study-Act cycle.</p><p><strong>Results: </strong>There was a marked improvement in the quality of anthropometric measurements, particularly in length measurement for children <24 months of age (0% at baseline vs 81.0% at end-line). However, the improvement in weight measurement of children less than 5 years was lesser (16.2% at baseline vs 44.6% at end-line).</p><p><strong>Conclusion: </strong>Anthropometric assessment of under-5 children can be standardised through the involvement of all stakeholders and capacity building of the concerned healthcare providers, using the QI approach. Repeated assessments are required to ensure the sustainability of the change.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11168152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and evaluation of a national quality improvement initiative in cancer surgery.","authors":"Angel Arnaout, Shaheena Mukhi, Jamie Brehaut, Sarah Davidson, Michael Fung Kee Fung, Pamela Hebbard, Christopher Hillis, Robyn Leonard, Lloyd A Mack, Alex Mathieson, Justin Presseau, David Schaeffer, Andrew Seely, Gavin Stuart, Marvin Tesch, Nicholas Westhuizen, Craig Earle","doi":"10.1136/bmjoq-2024-002759","DOIUrl":"10.1136/bmjoq-2024-002759","url":null,"abstract":"<p><strong>Background: </strong>In 2017, the Canadian Partnership Against Cancer, a Canadian federally sponsored organisation, initiated a national multijurisdictional quality improvement (QI) initiative to maximise the use of synoptic data to drive cancer system improvements, known as the Evidence for Surgical Synoptic Quality Improvement Programme. The goal of our study was to evaluate the outcomes, determinants and learning of this nationally led initiative across six jurisdictions in Canada, integrating a mix of cancer surgery disease sites and clinicians.</p><p><strong>Methods: </strong>A mixed-methods evaluation (surveys, semistructured interviews and focus groups) of this initiative was focused on the ability of each jurisdiction to use synoptic reporting data to successfully implement and sustain QI projects to beyond the completion of the initiative and the lessons learnt in the process. Resources provided to the jurisdictions included operational funding, training in QI methodology, national forums, expert coaches, and ad hoc monitoring and support. The programme emphasised foundational concepts of the QI process including data literacy, audit and feedback reports, communities of practice (CoP) and positive deviance methodology.</p><p><strong>Results: </strong>101 CoP meetings were held and 337 clinicians received feedback reports. There were 23 projects, and 22 of 23 (95%) showed improvements with 15 of 23 (65%) achieving the proposed targets. Enablers of effective data utilisation/feedback reports for QI included the need for clinicians to trust the data, have comparative data for feedback, and the engagement of both data scientists and clinicians in designing feedback reports. Enablers of sustainability of QI within each jurisdiction included QI training for clinicians, the ability to continue CoP meetings, executive and broad stakeholder engagement, and the ability to use pre-existing organisational infrastructures and processes. Barriers to continue QI work included lack of funding for core team members, lack of automated data collection processes and lack of clinician incentives (financial and other).</p><p><strong>Conclusion: </strong>Success and sustainability in data-driven QI in cancer surgery require skills in QI methodology, data literacy and feedback, dedicated supportive personnel and an environment that promotes the process of collective learning and shared accountability. Building these capabilities in jurisdictional teams, tailoring interventions to facility contexts and strong leadership engagement will create the capacity for continued success in QI for cancer surgery.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11168180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relevance of meeting general outpatients' information needs to their perceptions of healthcare quality in a hospital in Ghana: a Healthcare Quality Survey using modified SERVQUAL analysis.","authors":"Anita Ago Asare, Elom Otchi, Adom Manu","doi":"10.1136/bmjoq-2023-002683","DOIUrl":"10.1136/bmjoq-2023-002683","url":null,"abstract":"<p><strong>Background: </strong>Patients determine quality of healthcare by their perception of the gap between the healthcare they experience/receive and that which they expect. This can be influenced by the ability of healthcare staff to adequately communicate information about the healthcare provided. This study assessed the level of relevance of meeting patients' information needs with respect to their assessment of healthcare quality in a private hospital's general outpatient department in Ghana.</p><p><strong>Design: </strong>Study design was cross-sectional using exit self-administered questionnaires among 390 outpatients. Healthcare quality was measured using a modified form of the Service Quality model gap analysis (gap between experience and expectations). A negative gap signifies unmet patient expectations. Microsoft Excel and Stata V.15.0 were used for analysis using t-test and multiple linear regression. A p value ≤0.05 denotes statistical significance.</p><p><strong>Findings: </strong>The mean percentage of patients' expectations of quality of healthcare was 87.6% (SE 0.031), while patient experience was 86.0% (SE 0.029), with a significant negative gap of -0.08 (p<0.002). Their highest expectation of the quality of healthcare was for their information needs to be met, with a mean score of 4.44 (SE 0.03). Two of the four items under the information needs dimension that showed no statistically significant gaps were 'saying all their problems' (gap=0.00; p<0.9) and 'explanation of treatment/medications' (gap=0.01; p<0.6). Those with statistically significant negative gaps were 'explanation of investigations and procedures' (gap=-0.18; p<0.0001) and 'explanation of the diagnoses' (gap=-0.11; p<0.02), signifying unmet expectations.</p><p><strong>Conclusions: </strong>The outpatient's greatest need for quality healthcare in this study was for their information needs to be met. Providing information on patient diagnoses and investigations are the areas least likely to be adequately communicated to patients.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11168125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Codesign and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth.","authors":"Abi Merriel, Miriam Toolan, Mary Lynch, Gemma Clayton, Andrew Demetri, Lucy Willis, Narendra Mampitiya, Alice Clarke, Katherine Birchenall, Chloe de Souza, Emma Harvey, Tamarind Russell-Webster, Eva Larkai, Mariusz Grzeda, Kate Rawling, Sonia Barnfield, Margaret Smith, Rachel Plachcinski, Christy Burden, Abigail Fraser, Michael Larkin, Anna Davies","doi":"10.1136/bmjoq-2023-002731","DOIUrl":"10.1136/bmjoq-2023-002731","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to codesign, implement, evaluate acceptability and refine an optimised antenatal education session to improve birth preparedness.</p><p><strong>Design: </strong>There were four distinct phases: codesign (focus groups and codesign workshops with parents and staff); implementation of intervention; evaluation (interviews, questionnaires, structured feedback forms) and systematic refinement.</p><p><strong>Setting: </strong>The study was set in a single maternity unit with approximately 5500 births annually.</p><p><strong>Participants: </strong>Postnatal and antenatal women/birthing people and birth partners were invited to participate in the intervention, and midwives were invited to deliver it. Both groups participated in feedback.</p><p><strong>Outcome measures: </strong>We report on whether the optimised session is deliverable, acceptable, meets the needs of women/birthing people and partners, and explain how the intervention was refined with input from parents, clinicians and researchers.</p><p><strong>Results: </strong>The codesign was undertaken by 35 women, partners and clinicians. Five midwives were trained and delivered 19 antenatal education (ACE) sessions to 142 women and 94 partners. 121 women and 33 birth partners completed the feedback questionnaire. Women/birthing people (79%) and birth partners (82%) felt more prepared after the class with most participants finding the content very helpful or helpful. Women/birthing people perceived classes were more useful and engaging than their partners. Interviews with 21 parents, a midwife focus group and a structured feedback form resulted in 38 recommended changes: 22 by parents, 5 by midwives and 11 by both. Suggested changes have been incorporated in the training resources to achieve an optimised intervention.</p><p><strong>Conclusions: </strong>Engaging stakeholders (women and staff) in codesigning an evidence-informed curriculum resulted in an antenatal class designed to improve preparedness for birth, including assisted birth, that is acceptable to women and their birthing partners, and has been refined to address feedback and is deliverable within National Health Service resource constraints. A nationally mandated antenatal education curriculum is needed to ensure parents receive high-quality antenatal education that targets birth preparedness.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11168157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}