Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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Introduction of structured competency-based training for specialty registrars and implementation of European Working Time Directives (EWTD) have affected the quality of maternity care. In York District Hospital, consultant resident on-call (CRO) without registrar cover was introduced in July 2010 to address the long-standing problem of middle-grade out-of-hours coverage. To examine the impact of introducing out-of-hours consultant resident on-call on maternity care, data from 486 deliveries including 59 CRO and 59 registrar shifts were collected retrospectively, from July 2010 to April 2011. ⋯ Overall, good patient and staff experience was reflected during interviews. Our work shows that introduction of CRO in out-of-hours settings is acceptable among staff and is associated with fewer obstetric interventions. However, improved job descriptions may be needed in order to make the CRO post more attractive.
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The latest Confidential Enquiry into Maternal Deaths (2006-2008) shows that venous thromboembolism (VTE) is now the third leading cause of direct maternal mortality, behind sepsis and hypertension. This is likely to be because of improved risk assessment of patients and adequate thromboprophylaxis both antenatally and postnatally. ⋯ The findings led to a revised guideline, and it was anticipated that this change would facilitate improved compliance. Other units are likely to be facing similar difficulties, and therefore these results also aim to encourage others to consider review and assessment of their own VTE risk assessment protocols.