Obstetric audit: the Bradford way.

Area of Science:

• Obstetric Ultrasound
• Fetal Medicine
• Quality Improvement in Healthcare

Background:

• Ultrasound is a key screening tool in obstetrics to reduce maternal and fetal morbidity.
• Effective screening relies on standardized protocols and consistent scanning practices, often ensured through audits.
• Bradford's diverse population has high rates of birth defects, necessitating an effective fetal anomaly screening service.

Purpose of the Study:

• To implement and evaluate a rolling audit program for dating, fetal anomaly, and growth scans.
• To assess the impact of audits and retraining on sonographer performance and adherence to national guidelines.
• To determine if the department met national detection rates for the Fetal Anomaly Screening Programme.

Main Methods:

• A rolling audit program was implemented for dating, fetal anomaly, and growth scans performed by sonographers.
• Audits used measurable parameters based on national guidelines.
• Feedback and retraining were provided to address identified issues, followed by re-audits.

Main Results:

• Re-audits showed marked improvement in sonographer practice after feedback and retraining for dating and fetal anomaly scans.
• The department achieved nationally agreed detection rates for auditable conditions within the Fetal Anomaly Screening Programme.
• Audit was confirmed as essential for consistent scanning practices and high-quality obstetric ultrasound imaging and measurements.

Conclusions:

• Auditing obstetric ultrasound scanning practices is a valuable and essential process for ensuring quality and consistency.
• Quality improvement initiatives, including audits and retraining, lead to significant enhancements in sonographer performance.
• The implemented audit program successfully improved fetal anomaly detection rates to meet national standards.