Maternity improvement resource

What we look for 

Safe

Safe systems, pathways and transitions

Telephone triage:

• Do you use a standardised form to document calls to triage?
  • Is there space to document the time of calls?
  • How are frequent callers identified?
  • Are the phone numbers clearly signposted?

In-person triage:

• How are women assessed and their care prioritised?
• Is there a standardised tool?
  • If so, can you talk us through it?
• Do you complete the patient care record?
• When women are classed as high-risk, how are they prioritised?
• When women present in early or established labour, do you carry out a full clinical assessment?
  • If not, are they on a different pathway?
• Do you use a formal tool when handing over care to other areas?
• What is the protocol in place for handling an obstetric emergency in triage?
• How do you ensure you listen and record the preferences and decisions communicated by women? Do you have time to do so?

Safe environments

• What emergency equipment is available in triage?
• Do you complete checks on emergency equipment and how often?
• Is there space for privacy if needed?
• Is there a ligature point risk assessment of the environment?
• Is the triage waiting area visible to staff?

Safe and effective staffing

• Do triage staffing and acuity issues feed into the maternity unit safety huddle?
  • Are you invited to attend in person or remotely?
• What training have you had to work in triage?
• What training have you had to answer telephone triage?
• Do you have targets for women to be seen by midwives and doctors?
  • What are they?
• Do you record the time of arrival of women?
• Do you record what time they are seen by a midwife?
• Do you record what time they are seen by a doctor?

Safe medicines optimisation

• How are medicines prescribed (paper or electronic), by whom?
• Are you able to access medicines easily? 

Effective

Assessing needs/delivering evidence-based care and treatment

• Are you able to access diagnostic results in a timely manner?
• Do you use the Modified Early Obstetric Warning Score (MEOWS) for clinical observations?
• Are you able review scans and sign the outcomes? 

Monitoring and improving outcomes

• Do you know how waiting times are monitored?
• Do you know how triage proformas are audited to include appropriate completion, prioritisation and escalation?
  • How are the results of these audits shared?