OBJECTIVE: To assess the introduction of Practical Obstetric Multi-professional Training (PROMPT) into maternity units and evaluate effects on organisational culture and perinatal outcomes. DESIGN: A retrospective cohort study. SETTING: Maternity units in eight public hospitals in metropolitan and regional Victoria, Australia. POPULATION: Staff in eight maternity units and a total of 43,408 babies born between July 2008 and December 2011. METHODS: Representatives from eight Victorian hospitals underwent a single day of training (Train the Trainer), to conduct PROMPT. Organisational culture was compared before and after PROMPT. Clinical outcomes were evaluated before, during and after PROMPT. MAIN OUTCOME MEASURES: The number of courses run and the proportion of staff trained were determined. Organisational culture was measured using the Safety Attitude Questionnaire. Clinical measures included Apgar scores at 1 and 5 minutes (Apgar 1 and Apgar 5), cord lactate, blood loss and length of baby's stay in hospital. RESULTS: Seven of the eight hospitals conducted PROMPT. Overall about 50% of staff were trained in each year of the study. Significant increases were found in Safety Attitude Questionnaire scores representing domains of teamwork (Hedges' g 0.27, 95% confidence interval [95% CI] 0.13-0.41), safety (Hedges' g 0.28, 95% CI 0.15-0.42) and perception of management (Hedges' g 0.17, 95% CI 0.04-0.31). There were significant improvements in Apgar 1 (OR 0.84, 95% CI 0.77-0.91), cord lactates (odds ratio 0.92, 95% CI 0.85-0.99) and average length of baby's stay in hospital (Hedges' g 0.03, 95% CI 0.01-0.05) during or after training, but no change in Apgar 5 scores or proportion of cases with high blood loss. CONCLUSION: PROMPT can be introduced using the Train the Trainer model. Improvements in organisational culture and some clinical measures were observed following PROMPT.
OBJECTIVE: To assess the introduction of Practical Obstetric Multi-professional Training (PROMPT) into maternity units and evaluate effects on organisational culture and perinatal outcomes. DESIGN: A retrospective cohort study. SETTING: Maternity units in eight public hospitals in metropolitan and regional Victoria, Australia. POPULATION: Staff in eight maternity units and a total of 43,408 babies born between July 2008 and December 2011. METHODS: Representatives from eight Victorian hospitals underwent a single day of training (Train the Trainer), to conduct PROMPT. Organisational culture was compared before and after PROMPT. Clinical outcomes were evaluated before, during and after PROMPT. MAIN OUTCOME MEASURES: The number of courses run and the proportion of staff trained were determined. Organisational culture was measured using the Safety Attitude Questionnaire. Clinical measures included Apgar scores at 1 and 5 minutes (Apgar 1 and Apgar 5), cord lactate, blood loss and length of baby's stay in hospital. RESULTS: Seven of the eight hospitals conducted PROMPT. Overall about 50% of staff were trained in each year of the study. Significant increases were found in Safety Attitude Questionnaire scores representing domains of teamwork (Hedges' g 0.27, 95% confidence interval [95% CI] 0.13-0.41), safety (Hedges' g 0.28, 95% CI 0.15-0.42) and perception of management (Hedges' g 0.17, 95% CI 0.04-0.31). There were significant improvements in Apgar 1 (OR 0.84, 95% CI 0.77-0.91), cord lactates (odds ratio 0.92, 95% CI 0.85-0.99) and average length of baby's stay in hospital (Hedges' g 0.03, 95% CI 0.01-0.05) during or after training, but no change in Apgar 5 scores or proportion of cases with high blood loss. CONCLUSION: PROMPT can be introduced using the Train the Trainer model. Improvements in organisational culture and some clinical measures were observed following PROMPT.
Authors: S E Edwards; S Platt; E Lenguerrand; C Winter; J Mears; S Davis; G Lucas; E Hotton; R Fox; T Draycott; D Siassakos Journal: BMJ Simul Technol Enhanc Learn Date: 2015-10-05
Authors: Jette Led Sørensen; Cees van der Vleuten; Susanne Rosthøj; Doris Østergaard; Vicki LeBlanc; Marianne Johansen; Kim Ekelund; Liis Starkopf; Jane Lindschou; Christian Gluud; Pia Weikop; Bent Ottesen Journal: BMJ Open Date: 2015-10-06 Impact factor: 2.692
Authors: Arunaz Kumar; Sam Sturrock; Euan M Wallace; Debra Nestel; Donna Lucey; Sally Stoyles; Jenny Morgan; Peter Neil; Michelle Schlipalius; Philip Dekoninck Journal: BMJ Open Date: 2018-02-17 Impact factor: 2.692