Improvement Story Five

Northwest London Hospitals 

Contributors: Dr Evangelia Myttaraki, ST3 Paediatric Trainee, [email protected] Dr Enitan Ogundipe, Consultant in Neonatology, [email protected]

Brief description of initiative

The Obstetric Neonatal Interest Teaching (ONIT) is a multi-disciplinary perinatal study day across Northwest London hospitals. The focus of the idea is to improve knowledge on perinatal medicine, to build effective perinatal teams and underline the importance of multidisciplinary approach in improving neonatal outcomes. The idea derived from a phrase I once heard while I was talking to some other junior paediatric doctors: “during my training I have never had any combined teaching about the things I see and hear in the delivery room and in maternity meetings everyday”. This made me want to create an opportunity that will bridge the gap between prenatal and postnatal care, that will promote a healthy collaboration based on basic knowledge of each other’s specialty thus building stronger and more successful perinatal teams.

ONIT is targeted to all involved in perinatal care; paediatric, neonatal and obstetric trainees of all grades, anaesthetic trainees interested in obstetric anaesthesia, and midwives. It involves a set of 20-40min talks on topics that cover all the journey from pre-conception up until after delivery. What is unique about ONIT is that the topics are practical and based on real scenarios that have happened in maternity wards, labour theatres and neonatal units across the country. ONIT is delivered by specialists in their fields who have a passion to share the knowledge and improve perinatal care.

What aspects of culture did you focus on and what changes did you make?

ONIT is an opportunity to better understand perinatal care, by recognizing the role that each one of us play. Starting with the basic knowledge, and extending to communication skills, ONIT provides a multi-disciplinary approach to learning. It is an open invitation to cross-specialty teaching and it is proof that practising medicine means being open minded and knowledgeable of other’s specialties that affect the care that you provide in your own field. ONIT was welcomed across northwest London with great success and several hospitals such as Chelsea & Westminster, Northwick Park, and Hillingdon have expressed their interest to lead the sessions on the day. Coordination and advertisement of the event is held at a hospital level, therefore everyone’s contribution to ‘spreading the word’ has been fantastic.

What effect this has had on your team culture?

ONIT is led by junior trainees (neonatal, obstetric, anaesthetic) with direct support by the Consultant body. The contribution of midwifery teams and pharmacists is also exceptional. This multi-disciplinary involvement is what makes ONIT a cornerstone of team building and team culture. When different teams get involved in a project with a common aim, then all participants gain valuable experience and become truly engaged. Moreover, the fact that several hospitals across Northwest London participate in ONIT gives everyone the opportunity to work on projects with trainees from different Trusts, thus building on the principles of team spirit and cooperation.

What barriers have you had to overcome?

Leading a project that runs across different hospitals and Trusts requires exquisite organisational, managerial and leadership skills. The COVID-19 pandemic made the launching of ONIT even harder. This year we aim to deliver ONIT across hospitals in Northwest London by offering both virtual and face-to-face attendance. We hope that the barriers caused by the pandemic, the shortage of staffing, and the high clinical workload can be left in the past, so as ONIT participants can take study leave and attend the programme as ‘protected time’.

What helped to make this successful?

Our determination to create and launch ONIT across Northwest London is key to its success. We hope that this project will continue to be delivered yearly, as it offers a multi-disciplinary team approach to learning. We support junior trainees to lead several talks which cover all the journey from pre-conception up until after delivery, as proof that perinatal care is dependent on good communication and cooperation amongst specialists. We believe that ONIT fits perfectly along the lines of BAPM priority focus in perinatal optimization, and we strongly recommend the implementation of ONIT in other hospital affiliations and networks.