COVID-19 and maternity care in South East London: shared working and learning initiative

BMJ Open Quality

article

Emily Steward¹  Jacqui Kempen¹  Caroline Wright²  Carol Postlethwaite³  Monica Franklin⁴  Laura Onwubalili²  Aisha Hameed⁵  Sadia Bhatti⁵  Oladimeji Olowu²  Daghni Rajasingam⁴  Anita Banerjee⁴ 

[1] NHS SEL CCG Planning and Commissioning , Local Maternity System;Obstetrics and Gynaecology Department;Obstetrics and Gynaecology Department , Medway NHS Foundation Trust;Women's Services , Guys and St Thomas' Hospitals NHS Foundation Trust;Obstetrics and Gynaecology Department , King's College Hospital NHS Foundation Trust

关键词: COVID-19;    obstetrics and gynecology;    quality improvement;    safety culture;    teamwork;   

DOI  :  10.1136/bmjoq-2021-001340

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

The SARS-CoV-2 COVID-19 pandemic has had an immediate and profound impact on how healthcare systems organise and deliver services and specifically, there is a disproportionate negative impact on Black, Asian and Minority Ethnic groups and other risk factors. This has required clinical leaders to respond at pace to meet patient’s care needs, while supporting staff working in a volatile, uncertain, complex and ambiguous environment. During the initial wave and then the later waves within our South East London sector, there were new challenges as everyone faced a novel disease necessitating real-time learning and reflection. Through informal conversations and networks, the clinicians highlighted in the first wave the need for a forum for clinical discussion. Using our existing South East London Local Maternity System and the evolving Maternal Medicine Networks alliance, we initiated a sharing and learning platform to support clinical decision-making for all maternity health professionals during the pandemic. Fortnightly, multidisciplinary virtual huddles were established allowing obstetric physicians, obstetricians, midwives and obstetric anaesthetists to share their clinical experience, operational and service challenges. This approach fostered and developed cross-site team working and shared learning across traditional, organisational boundaries. In South East London, prior to the introduction of universal testing in the first surge, we had a total of 65 confirmed positive cases of which 5 women were delivered due to COVID-19, 5 women required high dependency or intensive care and 3 women were intubated and ventilated. During the second and third waves, the COVID-19 Local Maternity System huddles provided monthly learning opportunities to share clinical practice, guidelines, vaccination updates and challenges with workforce. The huddles have proven to be a sustainable platform, which have built trust across the sector, facilitating effective teamwork and providing invaluable support for clinical decision-making. We describe the evolution of this structure and share our experience of working within this new clinical network during the first wave and how this established way of working facilitated collaboration during the second and third waves as staff and the system became more fatigued. The huddles have developed to become multi-professional, multisite collaborations with the whole group taking joint ownership to develop shared learning and are providing a forum for discussions for the emerging South East London’s Maternal Medicine Network.COVID-19obstetrics and gynecologyquality improvementsafety cultureteamworkData availability statementNo data are available.http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND