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    About the project

    The PPH Collaborative took place between April 2022 and April 2023 (phase 1) and was attended by 33 health service teams. Between August and December 2023 we offered additional support to 27 maternity teams who expressed an interest in continuing work in reducing PPH.

    This collaborative aimed to reduce harm to families and health professionals by standardising and improving the response to PPH across participating Victorian health services.  Arguably the most powerful impact of the project was improved recognition of PPH through the broad scale implementation of Quantified Blood Loss measurement (QBL). This important clinical and cultural transition from visually estimating blood loss, which has long been identified as inaccurate within scientific literature, has increased both the recognition of PPH and the transparency of Victorian PPH rates, leading to significant improvements in obstetric safety.

    Background

    In Victoria, postpartum haemorrhage (or PPH) caused 37 per cent of all severe acute maternal morbidity reported in 2019. Research suggests it is often avoidable.

    There is increasing evidence of the psychological effects of PPH including impacts on breastfeeding, bonding, and contact time between the parents and baby. Health professionals can also be impacted by a fear of managing future PPH cases.

    Evaluation report

    Evaluation report - Postpartum Haemorrhage Collaborative

    Improvement toolkit

    This resource is for maternity services who are working to reduce the rate of postpartum haemorrhage during childbirth. It contains quality improvement foundations and the change package improvement theory developed for the Postpartum Haemorrhage (PPH) Collaborative.

    Audit tool

    This audit tool provides a way of recording and graphing monthly data for data monitoring and measuring. It offers a step-by-step guide on how to identify files for review for process measure audits, so they are randomised.

    Educational videos

    These educational videos support management and improvement initiatives to reduce the incidence of PPH.  They cover a broad range of topics from:

    • implementation of quantified blood loss measurement (QBL)
    • pharmacological management 
    • escalation of PPH 
    • consumer engagement and support. 

    Part 1

    Gill from Peninsula Health discusses the experience of introducing QBL into their maternity unit and provides insights into improvement science approaches to change.

    Part 2

    Siobahn from Albury Wodonga Health discusses the experience of introducing QBL into their maternity unit and provides insights into improvement science approaches to change.

    Trigger point for calling postpartum haemorrhage

    Dr Lauren De Luca discusses considerations in escalation of the PPH response including suggested trigger points for escalation.

    Imminent postpartum haemorrhage

    Emma from West Gippsland Healthcare Group discusses their escalation initiative "Imminent PPH", implemented as part of their improvement program during the PPH Collaborative.

    Dr Warrick Pill discusses the contemporary evidence behind pharmacological management of PPH.

    Consumer Support in postpartum haemorrhage

    Alicia from Monash Health discusses how they implemented a dedicated patient support clinician within the emergency response to PPH.

    Consumer Engagement to Guide Improvement

    Amy from Swan Hill Health discusses engaging with consumers to guide improvement initiatives in clinical practice.

    Bella from Safer Care Victoria discusses the importance of organisational culture and contemporary evidence-based protocols for PPH management with clear triggers for escalation.

    Danni and Stephanie from Box Hill Hospital provide a tutorial to assist midwifery staff in the preparation of PPH medication.

    Caitlin from Joan Kirner Women's and Children's Hospital provides insight into the establishment of a midwife liaison program at Joan Kirner.

    Shannon from SCV provides a tutorial on how to use the Audit tool designed to support data mapping within health services that do not have access to a dashboard.

    A 100,000 Lives initiative

    100,000 Lives - every life is a story worth telling

    This project was part of the 100,000 Lives program. 

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