The Tommy's Clinical Decision Tool, a device for reducing the clinical impact of placental dysfunction and preterm birth: protocol for a mixed-methods early implementation evaluation study.

Female Focus Groups Health Personnel Humans Infant, Newborn Placenta Pregnancy Premature Birth / prevention & control Stillbirth
Decision support Implementation Pregnancy Preterm Process evaluation Risk assessment Stillbirth eHealth

Journal

BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799

Informations de publication

Date de publication:
15 Aug 2022
Historique:
received: 05 05 2022
accepted: 23 06 2022
entrez: 15 8 2022
pubmed: 16 8 2022
medline: 18 8 2022
Statut: epublish

Résumé

Disparities in stillbirth and preterm birth persist even after correction for ethnicity and social deprivation, demonstrating that there is wide geographical variation in the quality of care. To address this inequity, Tommy's National Centre for Maternity Improvement developed the Tommy's Clinical Decision Tool, which aims to support the provision of "the right care at the right time", personalising risk assessment and care according to best evidence. This web-based clinical decision tool assesses the risk of preterm birth and placental dysfunction more accurately than current methods, and recommends best evidenced-based care pathways in a format accessible to both women and healthcare professionals. It also provides links to reliable sources of pregnancy information for women. The aim of this study is to evaluate implementation of Tommy's Clinical Decision Tool in four early-adopter UK maternity services, to inform wider scale-up. The Tommy's Clinical Decision Tool has been developed involving maternity service users and healthcare professionals in partnership. This mixed-methods study will evaluate: maternity service user and provider acceptability and experience; barriers and facilitators to implementation; reach (whether particular groups are excluded and why), fidelity (degree to which the intervention is delivered as intended), and unintended consequences. Data will be gathered over 25 months through interviews, focus groups, questionnaires and through the Tommy's Clinical Decision Tool itself. The NASSS framework (Non-adoption or Abandonment of technology by individuals and difficulties achieving Scale-up, Spread and Sustainability) will inform data analysis. This paper describes the intervention, Tommy's Clinical Decision Tool, according to TiDIER guidelines, and the protocol for the early adopter implementation evaluation study. Findings will inform future scale up. This study was prospectively registered on the ISRCTN registry no. 13498237 , on 31

Sections du résumé

BACKGROUND BACKGROUND
Disparities in stillbirth and preterm birth persist even after correction for ethnicity and social deprivation, demonstrating that there is wide geographical variation in the quality of care. To address this inequity, Tommy's National Centre for Maternity Improvement developed the Tommy's Clinical Decision Tool, which aims to support the provision of "the right care at the right time", personalising risk assessment and care according to best evidence. This web-based clinical decision tool assesses the risk of preterm birth and placental dysfunction more accurately than current methods, and recommends best evidenced-based care pathways in a format accessible to both women and healthcare professionals. It also provides links to reliable sources of pregnancy information for women. The aim of this study is to evaluate implementation of Tommy's Clinical Decision Tool in four early-adopter UK maternity services, to inform wider scale-up.
METHODS METHODS
The Tommy's Clinical Decision Tool has been developed involving maternity service users and healthcare professionals in partnership. This mixed-methods study will evaluate: maternity service user and provider acceptability and experience; barriers and facilitators to implementation; reach (whether particular groups are excluded and why), fidelity (degree to which the intervention is delivered as intended), and unintended consequences. Data will be gathered over 25 months through interviews, focus groups, questionnaires and through the Tommy's Clinical Decision Tool itself. The NASSS framework (Non-adoption or Abandonment of technology by individuals and difficulties achieving Scale-up, Spread and Sustainability) will inform data analysis.
DISCUSSION CONCLUSIONS
This paper describes the intervention, Tommy's Clinical Decision Tool, according to TiDIER guidelines, and the protocol for the early adopter implementation evaluation study. Findings will inform future scale up.
TRIAL REGISTRATION BACKGROUND
This study was prospectively registered on the ISRCTN registry no. 13498237 , on 31

Identifiants

DOI: 10.1186/s12884-022-04867-w PMID: 35971107 PMC: PMC9377101
pubmed: 35971107
doi: 10.1186/s12884-022-04867-w
pii: 10.1186/s12884-022-04867-w
pmc: PMC9377101
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

639

Subventions

Organisme : Tommy's
ID : Tommy's National Centre for Maternity Improvement

Informations de copyright

© 2022. The Author(s).

Références

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Auteurs

Jenny Carter (J)

Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, 10th Floor, North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK. jenny.carter@kcl.ac.uk.
Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK. jenny.carter@kcl.ac.uk.
ORCID: 0000-0003-2550-6465

Dilly Anumba (D)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Department of Oncology and Metabolism, University of Sheffield, The Jessop Wing, Tree Root Walk, Sheffield, S10 2SF, UK.

Lia Brigante (L)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.

Christy Burden (C)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Academic Women's Health Unit, University of Bristol, Bristol Medical School, Southmead Hospital, Bristol, BS10 5NB, UK.

Tim Draycott (T)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK.

Siobhán Gillespie (S)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Department of Oncology and Metabolism, University of Sheffield, The Jessop Wing, Tree Root Walk, Sheffield, S10 2SF, UK.

Birte Harlev-Lam (B)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.

Andrew Judge (A)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Translational Health Sciences, University of Bristol, Bristol Medical School, Southmead Hospital, Bristol, BS10 5NB, UK.

Erik Lenguerrand (E)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Translational Health Sciences, University of Bristol, Bristol Medical School, Southmead Hospital, Bristol, BS10 5NB, UK.

Elaine Sheehan (E)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Maternal Medicine Department, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, London, SW17 0QT, UK.
Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0QT, UK.

Basky Thilaganathan (B)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0QT, UK.
Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, London, SW17 0QT, UK.

Hannah Wilson (H)

Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, 10th Floor, North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.

Cathy Winter (C)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
PROMPT Maternity Foundation, Department of Women's Health, The Chilterns, Southmead Hospital, Bristol, BS10 5NB, UK.

Maria Viner (M)

Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.
Mothers for Mothers, New Fulford Family Centre, Gatehouse Avenue, Bristol, BS13 9AQ, UK.

Jane Sandall (J)

Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, 10th Floor, North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Tommy's National Centre for Maternity Improvement, Royal College of Obstetricians and Gynaecologists/Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK.

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Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Groupes de discussion › The Tommy's Clinical Decision Tool, a device...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Personnel de santé › The Tommy's Clinical Decision Tool, a device...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The Tommy's Clinical Decision Tool, a device...
questionsmedicales.fr › Personnes › Tranches d'âge › Nourrisson › Nouveau-né › The Tommy's Clinical Decision Tool, a device...
questionsmedicales.fr › Structures de l'embryon › Placenta › The Tommy's Clinical Decision Tool, a device...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › The Tommy's Clinical Decision Tool, a device...
questionsmedicales.fr › Maladies urogénitales › Maladies de l'appareil urogénital féminin et complications de la grossesse › Complications de la grossesse › Complications du travail obstétrical › Travail obstétrical prématuré › Naissance prématurée › The Tommy's Clinical Decision Tool, a device...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Issue de la grossesse › Mortinatalité › The Tommy's Clinical Decision Tool, a device...