Context Induction of labour (IOL) is a very common medical intervention with current rates variable as 30-35% nationally. The rates are further increasing because of national drivers and maternity units in the UK are under immense pressure with capacity and staffing issues. Delays because of logistical challenges and understaffing have had a severe impact on patient and staff satisfaction. This area is not very well-studied, despite the severe impact the Covid-19 epidemic had on maternity services throughout the country. This QI project was bifold and aimed to explore the experiences of patients as well as staff during their IOL process at Lister Maternity Unit, understand their perspectives and seek improvement and solutions to the current process.

Data was collected using paper and online questionnaires for patients and staff. An information leaflet outlining the purpose of the study was provided with the questionnaire. Surveys included both open questions (for example, was there a delay to your induction and if yes, was it explained to you well?) as well as scoring questions (0-10) regarding communication, facilities and overall experience.

Surveys identified four main areas to improve: providing information about the process, planning of activity i.e., number of inductions per day, communication issues between clinical areas and managing patient expectations. Importantly, exploring both patient and staff perceptions helped to identify issues and possible solutions at the same time – for example, patients were often unhappy and worried about delays in their procedures and staff raised concerns about patients not being given enough information about the IOL process including the realistic time scale.

Overall, analysis of collected information helped us to develop cost-effective solutions: RAG system to help prioritisation of inductions, incorporation of patient-friendly tools, videos and improvement in current IOL information leaflets, a clerking or checklist proforma as a referencing source of discussion and more support from ward matrons and daily morning obstetric consultant ward rounds to aid communication. Information leaflets and videos have been shared with local maternity service networks (LMNS) and maternity voices partnership (MVP) as service user groups. These solutions will be now implemented at Lister Hospital and their efficacy will be continually evaluated and shared within LMNS.