Utilizing best practice methods to improve labour management in a partnership of five hospitals

To assess the use of "Best Practice" methods as a means of improving obstetrical care pertaining to labour management and Caesarean birth in a partnership group of 5 hospitals, 4 with birthing rates of 50 to 175 women a year, and the fifth with a birthing rate of approximately 1000 women a year.

The Labour Management module of the Advances in Labour and Risk Management (ALARM) Best Practice course of the Society of Obstetricians and Gynaecologists of Canada (SOGC) was tested on the 4 Level I rural hospitals and 1 modified Level II hospital in a small city in the Huron Perth Hospitals. The outcomes assessed were the module's effectiveness as a Continuing Medical Education (CME) tool; its effectiveness at promoting common practice guidelines; and its effectiveness at improving communication and co-operation.

From the 5 participating partnership hospitals, 3 obstetricians, 28 family physicians, and 5 midwives were eligible to participate. Of these 36 clinicians, 80% completed the Pre-study Phase, which included auditing their practice for Labour Management; 94% attended the workshops; and 67% completed the Post-study Audit. Common practice changes were identified through the workshops and post-study results showed success in their implementation. A Post-study Questionnaire indicated improved co-operation and communication in the partnership hospitals.

The Management of Labour module of the SOGC ALARM Best Practice course was successful in improving obstetrical practice in the partnership group of hospitals tested. This method promoted the use of common practice guidelines at the bedside and also improved communication and co-operation in the hospital partnership.