National preterm birth prevention collaborative conceived in WA | AMA (WA)


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National preterm birth prevention collaborative conceived in WA

Thursday December 22, 2022

By Beverly Ligman

It’s obvious from talking to Professor John Newnham AM that he’s passionate about his life’s work of lowering the preterm and early-term birth rate in Australia, and that it’s far from over.

As Chair of a new national collaborative program ‘Every Week Counts’, Professor Newnham will use his decades of experience as an obstetrician specialising in complicated pregnancies, to help educate 50+ maternity hospitals across Australia.

Prof Newnham heads the Australian Preterm Birth Prevention Alliance (the Alliance), which has partnered with Women’s Healthcare Australasia (WHA), the Institute for Healthcare Improvement (IHI) and Safer Care Victoria for the two-year collaborative improvement program.

The campaign aims to lower the rate of preterm and early term birth rate in Australia by 20 per cent over the next 18 months.

Every Week Counts is an IHI Breakthrough Collaborative Model that was designed to help organisations close the gap between what we know and what we do.

The model has been used successfully to dramatically improve health outcomes within regions and countries around the world for more than 25 years.

The Every Week Counts: National Preterm Birth Prevention Collaborative utilises this approach to enable achievement of the ambitious aim set by the Alliance.

Professor Newnham said being born too early remains the leading cause of death and disability in children up to five years of age in the developed world.

“Preventing this major complication of pregnancy and its far-reaching impacts needs to be one of our highest priorities in healthcare,” Prof Newnham said.

Every Week Counts aims to safely lower the rate of preterm and early-term birth within participating maternity units from across the country and leave an enduring culture of better practice.

The national collaborative is aimed at supporting Australian hospitals to deliver evidence-based changes in clinical care, and improve health outcomes for mothers and their babies.

“In recent years, the rate of preterm birth has been rising dramatically in many countries, including Australia. Across our population more than 8 per cent of births are too early, and in First Nation Australians the rate is almost double,” Prof Newnham added.

“At the moment we are doing training programs and just completed one in Sydney; these are not just a bunch of lectures, they’re team-building exercises aimed to get hospitals to work together, collaboratively. We teach them the interventions and the methodology, but it’s applied differently at every hospital depending on their size and their environment.

“The other part of the program is Life QI. This quality improvement platform gives hospitals real-time data and shares other hospitals’ data. So if you’re at Armadale Hospital you can see Bunbury Hospital’s data… and if they’re doing better than you in terms of lowering their preterm birth rate, you can ask them, ‘What are you doing that we’re not?’

“This is national team building and aims to help break down the barriers between hospitals. They’ll learn from each other, and it will create a bit of healthy competition too.”

Prof Newnham launched a state-wide program in WA in 2014, which was rolled out nationally in 2018 with funds from the NHMRC, and soon had positive results in ACT and Tasmania. However, it was discovered a different strategy for the bigger states was needed.

“What we’ve discovered through our work in this area, and what we didn’t know before, is that the definition of a mature fetus has been wrong. It’s not mature until 39 weeks; there’s massive growth and maturation that happens up until that time,” Prof Newnham said.

“It is terribly important in terms of the child’s brain as well as other organs. One in two elective caesareans have been done before 39 weeks in Australia for no good medical reason, and we’re now seeing that play out with behavioural and learning problems in schools.

“Up until this point, doctors haven’t known that. So, we need a massive education program around this to enable women to safely get to 39 weeks, and that’s part of what Every Week Counts aims to do.”

During the collaborative, participating hospital teams will be supported to accelerate their learning and develop reliable systems to ensure all women are offered the care and public health information that is known to reduce early birth. Teams will also be able to share their learnings with one another across Australia.

“We’re very proud of the fact this program was conceived in WA, trialled in WA, is run from WA, and will be rolled out from here,” Prof Newnham said.

“I need to acknowledge the passion and professionalism of my colleagues in neo-natal intensive care, but our job now is to prevent this from happening in the first place.

“At the end of this 18 months, if we’ve lowered the rate by 20 per cent, then we still have 80 per cent to go. I hope that the Government will continue to fund it, and hopefully more hospitals get involved in future collaboratives.”

Professor Newnham has been instrumental in preterm and early-term birth research in Australia.

In 1989, he founded and led the pioneering Raine Study of nearly 3,000 unborn babies in WA, with a view to studying them for life. The study continues to this day and is now intergenerational. He was also awarded the AMA (WA) Hippocrates Award in 2019 and named the national Senior Australian of the Year honour in 2020.

“I’ve had a truly blessed career supported by UWA, King Edward Memorial Hospital and the AMA (WA), but there’s still so much more work to be done. This is only the beginning.”

This article first appeared in the October-November edition of Medicus magazine: