How Benchmarking data supports Midwifery Group Practice (MGP) and Home Birthing at Sunshine HospitalSusan Gannon,Divisional Director,Women’s and Children’s Division

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Background

•Sunshine Hospital, Western Health is the third largest provider of birthing service in Victoria and the largest level 2 maternity unit in Victoria.

•In 2006 there were 3112 births, this has risen to 4429 births in 2011.

•Sunshine provides a funded 51-bed maternity unit, including 9 labour & birth rooms, 4 assessment bays, 32 post/antenatal beds, a 6-bed Pregnancy Day-Stay Unit (PDSU) and a 16 bed SCN.

•Women’s outpatient’s clinics offer services for pregnancy, complex pregnancy, gynaecology, well women & family planning.

•There are 59 community clinics offering midwife pregnancy care appointments.

•Women also have options for shared care with General Practitioners, midwifery care, caseload midwifery and home birthing.

•MGP Commenced in june 2008

•Homebirth Pilot commenced in January 2010

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Purpose of WHA benchmarking analysis at Sunshine Hospital•Assists the service to plan and improve our maternity services.

•Improves the overall quality of care by informing us about our performance, as well as to stimulate comparisons between other maternity units and to identify areas for further improvement.

•Serves as a clinical performance tool to enable us to monitor the implementation clinical governance principles on the ground and to reassure us regarding the ‘health’ of the service.

•Monitor various aspects of clinical governance contemporaneously, and take corrective action when there is deviation from expected performance.

• We can monitor specific clinical outcome parameters in order to understand the magnitude of a clinical problem, the adequacy of management and importantly to help us plan for resources, training and review of guidelines.

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Sunshine Hospital Data 2009-10

MGP (approx 3200 women given birth)

•Higher than average:

• % women giving birth vaginally (74.3%).• % attempted and have a successful VBAC.

•Lower than average :

• % of women giving birth vaginally who had an episiotomy• % of women giving birth who received an epidural for pain

relief• % PPH’s.

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Using this data to improve clinical practiceHome Birth (2010- March 2012 -108 given birth)

•Higher than average:

• % Vaginal birth rate (94.44%).

•Lower than average :

• % C/S for selected primiparas (6%)• %.C/S (4.68%)• % PPH’s (2.77%).