Perineal Trauma Clinic

Quality Improvement Poster Download




Background & Problems

Women who sustained a significant perineal trauma through childbirth were seen in the postnatal period by a consultant Obstetrician. This was booked in one of the busy of the busy ante natal clinics resulting in long wait times for the women and their new born babies. The women then had to attend a separate appointment with the physiotherapists.

Aim

The aim was to set to reduce the DNA rates and unnecessary additional clinic attendances for women. Thus improving the service we offer to women and reducing clinic costs, by replacing a consultant led clinic with a midwife led clinic.

Method

A proforma was devised and 30 set of notes were reviewed prior to the start of the pilot. Various elements were measured including the DNA rates, what level of clinician the women were seen by, did they see a physio, was there an examination performed. A further set of 30 set of notes were reviewed after the introduction of a joint midwife and physiotherapist led clinic.

Results

The introduction of the new midwife and physiotherapist led Perineal Trauma Clinic, has significantly reduced the consultant commitment to this clinic. 100% of women would see a consultant prior to the new clinic, with the introduction of the new clinic only women who required a consultant review were referred, this equated to less than 4% of the woment seen. The benefits of this is that the consultants can see more women in the ante clinic.

In addition to this DNAs halved and patients receiving physio has more than doubled with 96% of patients now seeing a physio. There are non-tangible benefits to women who no longer have to visit the hospital twice for their appointments. The dual clinic has also allowed better health promotion and education and improved multi disciplinary working.

Implications

The clinic is still a pilot a business case is currently being devised.