Women having their first birth vaginally in Victoria are four times more likely to experience a severe perineal laceration (third- or fourth-degree tear) compared to those having a subsequent birth vaginally (Victorian perinatal services performance indicators 2018–19 report).
This can have devastating long-term or lifelong impacts on physical and psychological wellbeing. Many of these tears are avoidable.
Research suggests that many stillbirths may be avoidable. We also know there is low awareness of the risk factors for stillbirth.
We teamed up with the Institute for Healthcare Improvement (IHI) and the Stillbirth Centre for Research Excellence (CRE) to improve outcomes for mothers and their babies, using the IHI’s proven Model for improvement.
This information will help you understand what documents to collect and keep as part of the review, and answer some of the common questions we receive about how you create, distribute, store and retain review documents.
Disclaimer: While it does not constitute legal advice, this information is useful for anyone involved in an incident review, including health service staff, consumers and external panel members. It is also helpful for health service executives, legal counsel, and quality, risk and safety leaders.
Partnering with consumers is key to driving improvements in healthcare for all Victorians.
Consumers have first-hand experience in the healthcare system and provide unique feedback that should be incorporated into all levels of the health system.
This guide provides information for healthcare agencies on how to engage with consumer representatives.
This information will support you and your health service to partner with consumer representatives.
When planning to engage a consumer representative, it’s important to set clear goals and outcomes.
Ask the following questions:
This project delivered education focused on two major risk factors for stillbirth: fetal growth restriction and decreased fetal movements.
In partnership with the Stillbirth Centre for Research Excellence (CRE), we implemented:
We continued to expand our Maternity and Neonatal ehandbooks, which give clinicians providing maternity care 24-hour access to pathways of care regardless of service location, capability or skill of workforce.
In 2018-19 we added a further 13 topics for our online maternity ehandbook, including antepartum haemorrhage, birth after caesarean, breech presentation, gestational diabetes and more.
We drove quality improvement by allowing maternity services to monitor their own data and clinical performance.
Services can now produce timely, regular dashboard style reports to immediately identify, escalate and respond to performance issues or clinical concerns.
Download our Maternity dashboard user guide
In 2018-19, we visited all maternity services to make sure they are accessing and using their new local maternity dashboards.
Gastro-oesophageal reflux is common in infants but is often misdiagnosed and treated unnecessarily with acid suppression therapy (AST) which can cause harm.
Prior to the pilot project commencing, we found that:
Sepsis is one of the leading causes of death in hospital patients worldwide. It is a time-critical illness requiring early identification and prompt intervention to improve patient mortality outcomes.
We introduced a statewide approach to sepsis assessment and management, and helped emergency departments and urgent care centres recognise and initially manage patients experiencing sepsis.