Delivery suite assessment unit: auditing innovation in maternity triage

Abstract

Delivery suite assessment unit: auditing innovation in maternity triageA Delivery Suite Assessment Unit (DSAU) has been established at a large Northern teaching hospital. This was as a recommendation of ASQUAM (achieving sustainable quality in maternity) to reduce antenatal admissions to delivery suite and provide a more appropriate environment for women attending for antenatal or labour assessment. The DSAU has also provided an effective teaching environment where skills such as effective telephone triage, diagnosis of labour and care of women with pre-labour spontaneous rupture of membranes (SROM) have been developed by junior staff. The first twelve months' audit results indicate that the establishment of the DSAU has been successful in reducing antenatal admissions to delivery suite by increasing the transfers of clients home, rather than to the antenatal wards. This may reflect the confidence of the highly skilled midwives working in this environment and the confidence women feel about their ability to obtain prompt and accurate advice over the telephone

Reducing length of stay for women who present as outpatients to delivery suite: A clinical practice improvement project

“…8 The second paper reports on the establishment of a Delivery Suite Assessment Unit in a large teaching hospital in the United Kingdom. 9 The Assessment Unit was established adjacent to the standard delivery suite. The aim of the new unit was to ''reduce antenatal admissions to delivery suite and provide a more appropriate environment for women attending for antenatal or labour assessment'' 9 , p. 506.…”

Pregnancy-related telephone consultations to an out-of-hours provider: a retrospective study

“…By this point, these women should have been 'booked' in for maternity care and informed about specific midwifery telephone consultation services available in their area. These may be midwifery led telephone consultation based in the community or labour ward areas (Cherry et al, 2009), or specific initiatives designed in local areas (Kennedy, 2007, Cherry et al, 2009, Nolan et al, 2007. Once booked, women should therefore have telephone access to midwives twenty four hours a day (Cherry et al, 2009).…”

“…In contrast, other studies have shown greater satisfaction and high quality of care with NP consultations, suggesting that there are benefits in expanding the role of NPs within primary care as whole (Seale et al, 2005, Horrocks et al, 2002. The skills required for effective telephone consultation in the health context are considered to be clinical expertise and communication skills essential for a role where no visual cues are available (Purc-Stephenson and Thrasher, 2010) as well as assessing clinical urgency and history taking (Nolan et al, 2007). Although many of these skills are generic, there is no current evidence on whether NPs need specific skills when handling pregnancy related telephone consultations.…”

“…'Booking' in the UK is recommended to take place by 10 weeks of pregnancy and at the latest is expected to have occurred by 13 weeks (NICE, 2008). In addition, some areas offer alternative telephone triage services with additional focus on consultation (Kennedy, 2007, Cherry et al, 2009, Nolan et al, 2007. However, their provision can be restricted, for example services only for women over twenty weeks' gestation (Nolan et al, 2007) or only providing services during office hours (Kennedy, 2007, Cherry et al, 2009.…”

“…In addition, some areas offer alternative telephone triage services with additional focus on consultation (Kennedy, 2007, Cherry et al, 2009, Nolan et al, 2007. However, their provision can be restricted, for example services only for women over twenty weeks' gestation (Nolan et al, 2007) or only providing services during office hours (Kennedy, 2007, Cherry et al, 2009. Despite current service provision, anecdotal evidence suggests that pregnant women also access OOH service providers, but the nature and volume of this contact is not well known.…”