Role Title: A quality improvement project (QIP) for improved prediction of preterm birth Intern
Organisation: North Metropolitan Health Service
Internship Period: Summer (November - December)
Location: Subiaco
Threatened preterm labour (TPTL) is a frequent reason for maternity assessment and admission, yet many women presenting with symptoms do not deliver imminently; upto 50% do not deliver preterm at all. Accurate clinical assessment is essential to target admission, corticosteroids, tocolysis and transfer, while avoiding unnecessary treatment and prolonged hospitalisation. Bedside clinical tests, including Actim Partus, PartoSure and transvaginal cervical length, should be used to guide this decision making. They may be employed as a tool to safely triage to ‘admission for monitoring’ or ‘discharge’. This project aims to evaluate current practice at KEMH and identify opportunities to improve admission decisions, reduce avoidable bed occupancy and costs, and develop a consistent assessment pathway. This work will inform the development of robust MFAU triage guidelines and potential for introduction of greater use of cervical length assessment, due to its clinical efficacy and cost benefits.
Project aims
1.Establish workload: Audit TPTL presentations, recording daily admissions, repeat attendances, length of stay and occupied bed-days.
2. Evaluate testing: Assess each test’s prediction of birth within 48 hours and seven days, and whether results influence admission, discharge, corticosteroids, tocolysis and transfer.
3. Identify improvements:
Established in 2016, North Metropolitan Health Services (NMHS) is committed to providing excellent health care for our patients and our communities.
As one of the largest health services in WA, we provide a comprehensive range of adult specialist medical, surgical, mental health and obstetric services.