OBS UK trial: Implementing a postpartum haemorrhage care bundle

Amrit Dhadda, Nathan Riddell, Sarah Bell   |   University Hospital of Wales, Cardiff, UK

Introduction

The NIHR-funded Obstetric Bleeding Study (OBS) UK trial is investigating the impact of implementing a postpartum haemorrhage (PPH) care bundle as a quality improvement (QI) initiative. The care bundle is based on previous work undertaken in Wales.1 

The trial will explore clinical and cost effectiveness and incorporates an embedded process evaluation.2

In total, 36 maternity units across England, Scotland and Northern Ireland have enrolled into the stepped-wedge cluster randomised controlled trial design (Figure 2). Sites have been randomised into six sequences. Sites within each sequence have a nine-month ‘implementation period’ to embed the bundle into their maternity units.

The objective of this project is to describe the implementation strategy of rolling out a OBS UK PPH care bundle into participating units across the UK.

Methods

An OBS UK national implementation team comprising obstetric, anaesthetic, midwifery and haematology specialists are leading the QI initiative. The methodology for the 9-month OBS UK implementation period has been informed by Medical Research Council recommendations, the implementation of OBS Cymru in Wales in 2016-18, and QI methodology guidance.1,3