Developing a national labour ward co-ordinator induction framework (maternity)
Rebecca Boore, Design and Development Manager (Perinatal), Health Education and Improvement Wales
Introduction
Health Education and Improvement Wales (HEIW), in collaboration with Strategic Leads of Midwifery across Wales, identified inconsistencies in the induction process for labour ward coordinators (LWCs) across Welsh health boards.
LWCs are crucial for setting safety standards and culture in maternity wards, but currently lack a standardised development pathway, as highlighted in recent reports on adverse maternal and neonatal outcomes.
Initial scoping revealed gaps in formal induction practices, leading to the development of an all-Wales framework to ensure consistent, high-quality induction and leadership training for LWCs.
Methods
To implement the labour ward coordinator (LWC) induction project, HEIW collaborated with health boards and stakeholders to address the lack of a standard induction process for this critical role.
A clinical LWC was seconded to HEIW for six months to develop an induction framework using the Model for Improvement and Plan, Do, Study, Act tools. Key stakeholders, including midwives, professional bodies, and universities, were engaged through surveys and meetings to ensure support and input.
The project was structured in three stages: framework development, implementation, and feedback collection.
Outcomes
- An all-Wales labour ward coordinator framework developed, covering four domains: education and training, research and evidence, expert clinical midwifery practice, and leadership.
- The framework standardises induction for aspiring, newly appointed, and current labour ward coordinators.
- Quantitative measurement: Tracking the number of new coordinators completing induction using the framework.
- Qualitative measurement: Collecting feedback from mentors and coordinators on the framework's impact, suggestions, and overall experience.
- Health boards are implementing the framework, with positive feedback highlighting its role in enhancing personal development, standardisation, and structured mentorship.
Learnings
- Seconding a clinical lead was highly beneficial due to their expertise and networks within NHS Wales.
- Timelines were ambitious; the project took longer than expected due to additional consultations, amendments, and translation and design.
- Challenges arose in obtaining baseline data, particularly regarding the number of labour ward coordinators in Wales.
- Survey design issues identified: the omission of key questions and the need for better engagement in survey development.
- Targeted communication and implementation was difficult, highlighting the need for early involvement of key stakeholders.
What next?
- Develop a survey to assess the use of the framework by newly appointed labour ward coordinators since April 2024. Gather feedback to improve response rates, addressing previous survey design challenges.
- Review and revise the framework based on feedback, benchmarking against NHS England’s framework.
- Future considerations: developing learning packages and similar frameworks for midwifery leadership roles.
