Finding the best way to scale up a perinatal Quality Improvement initiative: the PReCePT Study
Premature birth is the main cause of brain injury and cerebral palsy in babies. Evidence shows that babies can be protected from brain injury by giving magnesium sulfate to women who are at risk of having a premature delivery. This reduces the risk of cerebral palsy in a third of cases.
The PReCePT Study (Prevention of cerebral palsy in pre-term labour, also known as PReCePT2) is a research trial in 40 maternity units across England. The trial will assess which is the best method of implementation to improve and sustain magnesium sulfate uptake in maternity units, by comparing two different Quality Improvement (QI) approaches.
Quality Improvement is a systematic, formal approach to analysing the performance of health services and efforts to improve performance.
The research trial is funded by the Health Foundation Scaling Up Improvement Programme and will run from December 2017 – November 2020.
The trial is led by University Hospitals Bristol and Weston NHS Foundation Trust, in partnership with the National Institute for Health Applied Research Collaboration West (NIHR ARC West) and the West of England Academic Health Science Network (AHSN).
The Chief Investigator is Dr Karen Luyt, a neonatologist at St Michael’s Hospital in Bristol. NIHR ARC West is evaluating the trial.
The trial is nested within a wider national roll-out of PReCePT (the national PReCePT Programme). NIHR ARC West will be undertaking a separate evaluation of the national programme.
Project aims
The trial will assess whether an enhanced Quality Improvement (QI) intervention improves and sustains the uptake of magnesium sulfate in preterm deliveries (less than 30 weeks gestation) over and above a national programme roll-out being delivered via the AHSN network.
Trial units have been randomly allocated to receive either:
- Group 1 (control) = a standard support model of implementation of the PReCePT QI toolkit, as used in the national programme
- Group 2 (intervention) = an enhanced support model of implementation of the PReCePT QI toolkit
Units in group 2 receive the standard implementation in the national programme, plus:
- Bespoke QI coaching for their unit
- Access to three learning events and a celebration event
- Extra funded time for local clinical champions, over and above the backfill provided by the programme
- Funding for additional costs and a tablet computer
What we hope to achieve
This study aims to provide evidence to inform best practice for future perinatal Quality Improvement scaling up initiatives, such as the toolkit below.
QI innovation toolkit
This toolkit is designed to support you to build a strong foundation as a team before embarking on implementing change. The context these innovative tools were developed in is perinatal clinical care delivered by perinatal (midwifery, obstetric and neonatal) teams, however their use will be applicable to clinical care in general, where close collaboration is essential for ensuring the best patient outcomes.
- Download the toolkit (PDF)
- Citing this document:
Quality Improvement Innovation Toolkit, by Menzies N, Deogan V, Craggs P, Luyt K, is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License https://creativecommons.org/licenses/by-nc-nd/4.0/
Watch the latest PReCePT film
Paper
Scaling up an intervention to protect preterm infants from neurodevelopmental disabilities — findings from a qualitative process evaluation comparing standard with enhanced quality improvement support packages for maternity units in England
Read the paperRelated research projects
This project is part of a series of evaluations ARC West have done for PReCePT.
Lead collaborators
- Professor Karen Luyt, University Hospitals Bristol and Weston NHS Foundation Trust
- Dr Emma Treloar, University Hospitals Bristol and Weston NHS Foundation Trust
- Noshin Menzies, West of England Academic Health Science Network
- Vardeep Deogan, West of England Academic Health Science Network
- Anna Burhouse, RUBIS.Qi
ARC West Staff
Pippa Craggs
Chief Operating Officer
Dr Sabi Redwood
Implementation Lead
Dr Christalla Pithara-McKeown
Senior Research Associate, Qualitative Research
Professor Will Hollingworth
Cross-cutting Methodological Theme LeadPartners on this project
University Hospitals Bristol and Weston NHS Foundation Trust
University Hospitals Bristol and Weston NHS Foundation Trust is a dynamic group of hospitals in the heart of Bristol and Weston-Super-Mare, with over 100 clinical services across ten sites. They offer care to the people of Bristol, Weston-Super-Mare and the South West, and have an international reputation for cardiac surgery, paediatric services, oncology and bone marrow transplantation. They are the largest centre for medical training and research in the South West.
West of England Academic Health Science Network
The West of England Academic Health Science Network is a diverse network of partners working collaboratively to put innovation at the heart of healthcare, to improve patient outcomes and contribute to wealth creation. It aims to do this by translating research into practice, and developing and implementing integrated health care services.