Why is Southmead safe? Developing a programme theory of 'PROMPT' (PRactical Obstetric Multi-Professional Training)


Timescale: September 2014 - November 2017

Funder: Wellcome Trust Senior Investigator Award



Southmead hospital in Bristol has the safest maternity unit in the world. The unit has been running multi-professional training in managing obstetric emergencies (PROMPT) for 15 years; over this period the unit has seen improvements in their patient outcomes such as a 70% reduction in brachial plexus injuries, a 50% reduction in encephalopathy, and a 50% reduction in the time taken to expedite birth in potentially life-threatening cases of umbilical cord prolapse. Implementation of PROMPT has now been undertaken in sites beyond Southmead, including Australia, New Zealand, Zimbabwe, Hong Kong, China, the USA, Egypt, Mongolia and Singapore.

Rationale behind the study

A significant challenge to replicating successful interventions in patient safety is a lack of understanding of the social processes and mechanisms that result in improvements. Understanding how Southmead has become such a safe unit, and how the PROMPT training programme contributes to this, is critical in building knowledge about how to make maternity care safer.

The research study

We are using an ethnographic approach to understanding the mechanisms through which the improvements in safety have been achieved at Southmead, the role of the PROMPT intervention, and how the training programme interacts with contextual features to generate positive outcomes. Working with colleagues in Bristol we aim to generate a theory about what has contributes to the unit’s success, and what elements are vital to achieve the same success elsewhere.

For more information, please contact Mary Dixon-Woods

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