For the first time all private hospitals have been included in Safer Care Victoria’s report on perinatal services’ performance indicators.
The 2017–18 report enables both public and private health services to track their performance against a number of indicators, and against the performance of other same-level hospitals throughout Victoria. Safer Care Victoria plans to introduce targets for all indicators in the next report.
Safer Care Victoria’s benchmarking also enables health services to identify best practice in their field and highlights opportunities for improvements.
Improvements
The report shows an improvement in the number of babies born after 40 weeks with severe fetal growth restriction, dropping statewide from 30.8 per cent in 2016 to 28.1 per cent.
There was also improvement in smoking cessation in pregnancy, with an increase statewide from 26.1 per cent to 27.1 per cent. The rate of women attending their first antenatal visit by 12 weeks’ gestation increased from 45.4 per cent statewide in 2016 to 54.1 per cent in 2017.
Doing less well
Outcomes for the indicators ‘planned vaginal births after caesarean’ and ‘breastfeeding in hospital’ worsened, with the rate of women who planned vaginal births after caesarean dropping from 25.5 per cent in 2016 to 23.7 per cent in 2017 and the rate of achieved vaginal births dropping from 54.8 per cent to 52.4 per cent statewide.
The statewide rate of a breastfed baby’s final feed in hospital being taken directly and exclusively from the breast decreased from 76.8 per cent in 2016 to 75.1 per cent in 2017.
A Safer Care Victoria forum in February highlighted improvement activities underway in Victoria which include:
- a Women’s Healthcare Australasia collaborative on third and fourth degree perineal tears
- projects leading to improved rates of intended and actual vaginal birth after caesarian section
- the introduction of a neonatal sepsis calculator at Monash Health to reduce the admission rates of well babies at risk of sepsis to special care nurseries.
ANMF (Vic Branch) encourages midwives to read the report and discuss your service’s practice in relation to the performance indicators, if you are not already doing so.
Performance indicators include rates of perineal tears, episiotomies, caesarean sections and induction of labour.
Midwives should also take advantage of Safer Care Victoria education opportunities and discuss workload implications with health service management when changes in clinical care are proposed.