Task shifting: a key aspect to improving care for women at risk of preterm birth
Local problem Until April 2021, women presenting to maternity triage with symptoms of threatened preterm labour (TPTL) and/or preterm premature rupture of the membranes (PPROM) were triaged by a doctor. Depending on the acuity on the labour ward, women in triage often had a long wait for a doctor’s...
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| Format: | Article |
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BMJ Publishing Group
2025-08-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/14/3/e003104.full |
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| author | Naomi Carlisle Helena A Watson Laurence Nathalie Irene Frei Zoe Manton Mareike Bolten |
| author_facet | Naomi Carlisle Helena A Watson Laurence Nathalie Irene Frei Zoe Manton Mareike Bolten |
| author_sort | Naomi Carlisle |
| collection | DOAJ |
| description | Local problem Until April 2021, women presenting to maternity triage with symptoms of threatened preterm labour (TPTL) and/or preterm premature rupture of the membranes (PPROM) were triaged by a doctor. Depending on the acuity on the labour ward, women in triage often had a long wait for a doctor’s review. These delays create anxiety for women and impair the capacity of triage midwives to care for other women.Methods The Plan-Do-Study-Act method of quality improvement was used for this project. 3 months prior to the intervention, the baseline assessment was women’s wait time for medical review when presenting with TPTL and/or PPROM.Intervention Triage midwives were trained in performing speculum examination on preterm (<37 weeks’ gestation) women to allow quicker review. Waiting time for review by a midwife vs doctor was compared using data collected between January and December 2021.Results 88 eligible women were identified. 44 cases (intervention group) had their initial assessment by the triage midwife, while 44 cases (control group) had their initial assessment by a doctor. The mean waiting time between arrival and performance of quantitative fetal fibronectin (qfFN) in the intervention group was 67 min (SD=42.7), compared with 127 min (SD=61.2) in the control group (p<0.001). However, there was no significant difference in the waiting time between arrival and discharge/admission.Conclusion Women presenting with symptoms of TPTL are reviewed on average twice as quickly by the triage midwife compared with a doctor, allowing a quick reassurance for those where TPTL/PPROM has been excluded. However, the overall waiting time in triage was similar, as women in our unit currently need a doctor’s review before discharge. |
| format | Article |
| id | doaj-art-bb90a4878fc4406bac85ca8a620f4726 |
| institution | Kabale University |
| issn | 2399-6641 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-bb90a4878fc4406bac85ca8a620f47262025-08-22T10:35:11ZengBMJ Publishing GroupBMJ Open Quality2399-66412025-08-0114310.1136/bmjoq-2024-003104Task shifting: a key aspect to improving care for women at risk of preterm birthNaomi Carlisle0Helena A Watson1Laurence Nathalie Irene Frei2Zoe Manton3Mareike Bolten4research fellowDepartment of Women and Children`s Health, School of Life Course Sciences, King`s College London, London, UK1 Maternity, Lewisham and Greenwich NHS Foundation Trust, London, UK1 Maternity, Lewisham and Greenwich NHS Foundation Trust, London, UK1 Maternity, Lewisham and Greenwich NHS Foundation Trust, London, UKLocal problem Until April 2021, women presenting to maternity triage with symptoms of threatened preterm labour (TPTL) and/or preterm premature rupture of the membranes (PPROM) were triaged by a doctor. Depending on the acuity on the labour ward, women in triage often had a long wait for a doctor’s review. These delays create anxiety for women and impair the capacity of triage midwives to care for other women.Methods The Plan-Do-Study-Act method of quality improvement was used for this project. 3 months prior to the intervention, the baseline assessment was women’s wait time for medical review when presenting with TPTL and/or PPROM.Intervention Triage midwives were trained in performing speculum examination on preterm (<37 weeks’ gestation) women to allow quicker review. Waiting time for review by a midwife vs doctor was compared using data collected between January and December 2021.Results 88 eligible women were identified. 44 cases (intervention group) had their initial assessment by the triage midwife, while 44 cases (control group) had their initial assessment by a doctor. The mean waiting time between arrival and performance of quantitative fetal fibronectin (qfFN) in the intervention group was 67 min (SD=42.7), compared with 127 min (SD=61.2) in the control group (p<0.001). However, there was no significant difference in the waiting time between arrival and discharge/admission.Conclusion Women presenting with symptoms of TPTL are reviewed on average twice as quickly by the triage midwife compared with a doctor, allowing a quick reassurance for those where TPTL/PPROM has been excluded. However, the overall waiting time in triage was similar, as women in our unit currently need a doctor’s review before discharge.https://bmjopenquality.bmj.com/content/14/3/e003104.full |
| spellingShingle | Naomi Carlisle Helena A Watson Laurence Nathalie Irene Frei Zoe Manton Mareike Bolten Task shifting: a key aspect to improving care for women at risk of preterm birth BMJ Open Quality |
| title | Task shifting: a key aspect to improving care for women at risk of preterm birth |
| title_full | Task shifting: a key aspect to improving care for women at risk of preterm birth |
| title_fullStr | Task shifting: a key aspect to improving care for women at risk of preterm birth |
| title_full_unstemmed | Task shifting: a key aspect to improving care for women at risk of preterm birth |
| title_short | Task shifting: a key aspect to improving care for women at risk of preterm birth |
| title_sort | task shifting a key aspect to improving care for women at risk of preterm birth |
| url | https://bmjopenquality.bmj.com/content/14/3/e003104.full |
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