Learning how to replicate and scale a successful maternity safety improvement programme

After developing and adopting the PROMPT training programme, the Southmead maternity unit in Bristol has reported sustained improvements in maternity safety, including a reduction in clinical error and brachial plexus injuries. But propagating these successes beyond Southmead has not been straightforward: some units that implemented PROMPT have shown substantial improvement, while others have demonstrated more limited progress.

This suggests that the training on its own may not fully explain the outcomes seen at Southmead: the infrastructural, social, and cultural conditions that impact on safety need to be understood too.

This research aims to develop an understanding of what is needed to replicate and scale successful examples of improvement. It will examine the mechanisms underlying the safety outcomes seen at Southmead, including features of its context and of specific interventions such as the PROMPT training. It will then evaluate the extent to which these mechanisms are evident in a sample of other maternity units that have undertaken to implement PROMPT. Data will be collected through ethnographic observations and interviews with staff working in each unit.

The insights gained from this will be used to develop a training package that will include the original PROMPT training as well as recommendations on what needs to be in place for the programme to work. This training package will be tested and refined so that it is ready to be used in a robust trial setting.

The research will produce recommendations on the broader learning for generalisability, replication and scaling of improvement that advance both theory and practice.

Contact information

For more information about this project, please contact Mary Dixon-Woods, Professor of Health Services Research, Cambridge Centre for Health Services Research.