DESCRIPTION OF TOPIC:
PPH rates are rising nationally, with rates thought to have doubled between 2010 and 2023. In our unit, we were also experiencing increased rates, first noticed when we started weighing all blood loss at delivery, regardless of whether the team thought a PPH may have occurred or not. Our term vaginal PPH rate of >1500ml was as high as 7% each month. The UK target for this level of PPH is <3.3%. Several interventions had been tried and failed to make a difference until our MDT working group completed a deep dive into the management of PPH and discovered that several basic steps to reduce PPH rates weren’t being done despite local and national guidelines advising these steps. As a result of the intense training around ROBUST, our PPH has fallen from 7% to 3% most months. We still have not-so-good months when our rate goes above the recommended <3.3%, but when this occurs, we reinforce the ROBUST training with a deep dive to see where we may have further areas to improve, and case-based discussions emailed to the whole department, anonymized to share this learning. We hope that by sharing our quality improvement processes, other units will benefit from our learning.

RELEVANCE TO MIDWIFERY:
Improvement of midwifery practice to save lives by better education and skills drills on the management of postpartum hemorrhage. Adolescent care (including three-minute presentation competition)