PROMPT Wales
Our vision:
To reduce avoidable harm and improve perinatal outcomes, through multi professional training to enhance safety, teamwork and communication
PROMPT Wales (PRactical Obstetric Multi-Professional Training) is an evidence-based training programme which was implemented in NHS Wales maternity services in 2019. Funded by the Welsh Risk Pool, PROMPT Wales is coordinated by a National Team who support local faculty teams to organise and deliver training in their own unit to their own maternity teams.
A set of PROMPT Wales Standards guides Heath Boards with the sustainability of PROMPT Wales. All staff involved in maternity care are mandated to participate in PROMPT Wales training each programme year (September to August). In 2022-23 NHS Wales achieved over 90% attendance, this demonstrating the commitment to the programme by senior leadership teams, facilitation teams and the staff who attend every year.
PROMPT Wales includes scenario-based simulation sessions and workstations where staff have the opportunity to practise clinical skills and management of an emergency with an emphasis on teamworking. The relationship between human factors and safe care is seamlessly threaded throughout the training.
In-situ training tests systems and processes where small changes can be identified which contribute to organisation improvement. Through PROMPT Wales training, teams have embedded the use of algorithms, checklists and proformas to support clinical management and to reduce the opportunity for error.
Responsive to training needs, national data and confidential enquiry, the PROMPT Wales National Team have introduced training in the management of Impacted Fetal Head at Caesarean birth and developed a scenario-based training session on Diabetic Ketoacidosis in pregnancy. These new modules have been very well received by local teams and have evaluated positively.
More recently, PROMPT Wales has been used as a platform to familiarise teams with the importance of psychological safety in the workplace, civility, and the importance of timely escalation. Programmes are refreshed every year and are produced by local teams in collaboration with the national team as part of the quality assurance process.
The national team maintain strong, collaborative relationships with PROMPT Wales facilitation teams in the Health Boards, through national networking events, and regular visits to PROMPT Wales training days. To ensure high quality training is maintained year on year, quality assurance reviews are undertaken each academic year and a report is shared with the Health Board’s leadership teams. Excellent practice is celebrated and suggestions for continuous improvement are shared.
To ensure an optimum number of multi-professional faculty is maintained in each obstetric unit, the national team organise annual Faculty Development training. These one-day courses are designed to familiarise local facilitators with the PROMPT methodology to ensure a standardised approach to facilitation and training is received throughout Wales.
As well as being a popular training experience, PROMPT Wales is demonstrating improvements. A safety attitude questionnaire using a validated tool has demonstrated improvement in safety culture pre and post implementation of PROMPT Wales. Additionally, there has been a statistically significant improvement in APGAR scores of less than 7 at 5 minutes in both term and preterm babies, and a reduction in postpartum haemorrhage (PPH) of over 1500mL and 2500mL. We recognise the change in practice in the management of PPH in Wales through the OBS Cymru project but we are pleased to have supported the embedding and sustainability of the OBS Cymru approach to PPH management through PROMPT Wales. We are working with Welsh Government and the Strategic Clinical Network to expedite the development of a national dataset to support the evaluation of the impact of PROMPT Wales, IFS Wales and MoNET Wales.