Healthcare Safety Investigation Branch - 2 March 2023
Review identified an overarching theme around need to facilitate & support individualised risk assessments for pregnant women/people to improve maternity safety. Within this, 7 specific 'risk assessment themes' within maternity care pathway were identified from HSIB reports.
Risk assessment themes
The seven identified areas are as follows:
- The language used to discuss and document risk assessments should encourage a dynamic and holistic assessment of the individual pregnant woman/person's risk ('dynamic' means the risk is continually assessed to allow for unknown factors and to handle uncertainty, while 'holistic' refers to looking at other factors that might be relevant) that promotes the need for maternity care to be provided by multi-professional teams.
- Telephone triage services should support 24-hour access to a systematic structured risk assessment of pregnant women/people's needs.
- Telephone triage services should be operated by appropriately trained and competent clinicians who are skilled in the specific needs required for effective telephone triage.
- Face-to-face triage in maternity units should use a structured approach to prioritise pregnant women/people to be seen in order of clinical need.
- Clinicians should be enabled to proactively monitor and recommend the place of labour care and birth for pregnant women/people based on the individual's specific care needs during the course of their pregnancy and labour.
- Each pregnant woman/person should be helped to understand their individualised risk associated with a vaginal or caesarean birth after a previous caesarean birth, based on their specific risk factors and care needs.
- Pregnant women/people whose labour has been induced need clinical oversight and an individualised plan of care for maternal and fetal monitoring.
Read the Report - Assessment of risk during the maternity pathway
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