Using the Map of Medicine in maternity services: Major Postpartum Haemorrhage

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Using the Map of Medicine in maternity
servicesMajor Postpartum Haemorrhage

• Grace Thomas
• Consultant Midwife
• Gwent Healthcare NHS Trust
• June 2009

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Presentation will briefly review

• The What
• The Why
• The How
• The Who
• The Benefits
• Lessons learnt

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The What.

• Map of Medicine used to revise clinical guideline
  on major postpartum haemorrhage
• MoM Tool as benchmark evidence based care
• Local will to begin to revise all guidelines
  using MoM
• Pathway work being developed using MoM throughout
  organisation

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The Why.

• Serious clinical incident major PPH
• Investigation showed lack of clear clinical
  leadership during incident
• Failure of some systems and processes
• Clinical guideline did not clarify roles and
  responsibilities
• Clinical guideline wordy and not easy to follow

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The How.

• Wide group discussion involving blood bank,
  portering and telephony services as well as
  clinicians
• Sessions around computer to localise national
  guideline
• Frustration slow progress!
• Wide consultation
• Submission to MoM team once agreed
• Published local guideline
• Awareness raising

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The Who.

• Consultant Anaesthetist led the review of the
  guideline
• Consultant Midwife and Consultant Obstetrician
  worked in conjunction with Anaesthetist
• Project Lead for MoM

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Benefits

• Change in thinking, cultures and behaviour at all
  levels
• Debate / discussion amongst professional groups
  how emergency care should be delivered, by whom
  and priorities
• Highlighted difference in practice across teams
  sites
• Understanding of others roles / issues / views

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Lessons learnt.

• Small multi-professional group to review the
  guideline together / map clinical care
• Need acceptance of MoM as effective way of
  working prior to wide consultation
• Dont be afraid of MoM!
• Need to encourage staff to sign up to MoM
• Get MoM expert to help!
• Need good influencing skills to promote
  understanding and ownership

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• Thank you
• Grace.thomas_at_gwent.wales.nhs.uk