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Getting it right from the start

Establishing a Health Innovation and Education Cluster (HIEC) is helping to ensure that evidence-based practice is translated into frontline care, says Georgina Lessing-Turner, assistant director of the maternal and infant health and care theme of the Yorkshire and the Humber region HIEC.

Midwives magazine: Issue 5 :: 2011


From both service and education perspectives, there is substantial strength in health care in the generation of a robust evidence base. This strength is, however, not matched by the adoption and spread of such evidence. There is a recognised weakness in translating evidence into practice and policy and the Health Innovation and Education Cluster for Yorkshire and the Humber (HIEC) has been formed to address this weakness.

HIECs have their origin in Lord Ara Darzi’s report High quality care for all (Darzi, 2008). Darzi described HIECs as bringing together ‘many partners, across primary, community and secondary care, universities and colleges, and industry. They will be collaborations that set shared strategic goals for the benefit of member organisations. Their members will run joint innovation programmes that reflect their local needs and distinctiveness. They will also promote learning and education between their members’ (Darzi, 2008: 56).

The Yorkshire and the Humber HIEC, one of 17 across England, was established at the end of 2009. It is one of the largest nationally - it covers the whole region, including all NHS organisations and universities, and has three themes running simultaneously: long-term conditions; maternal and infant health and care, and patient safety. 

Its vision is for the introduction, adoption and spread of proven and innovative best practices in healthcare delivery, education, training and development.

We are based in the mother and infant research unit at the University of York and the Hull York Medical School and are supported and monitored by a multidisciplinary advisory group.
We work with existing regional and national groups, all maternity and neonatal services across the region, and stakeholders, supervisors of midwives and the local supervising authority midwifery officer.

We use local, regional and national data, relating to mothers and babies, in partnership with ChiMat, the national public health observatory for children and maternity. Our theme’s strapline is ‘getting it right from the start’.

What we are doing
As our remit is to introduce, adopt and spread proven and innovative best practice, we asked our stakeholders to identify priority areas. As a result, we undertook a consultation exercise in October 2010, which concentrated on the two main topics requested:
✲ Admission in labour
✲ Promoting attachment and breastfeeding in neonatal units.

We analysed the data from this consultation through an electronic questionnaire, supported by a regional workshop for each topic.

The consultation asked colleagues from a variety of backgrounds to score the impact of adopting evidence-based recommendations, and the feasibility of this happening. They were also asked to identify barriers, strategies and ideas for change, and give some best practice examples. A report (Yorkshire and the Humber HIEC, 2011) has been disseminated; the findings of which largely will inform our next major project work, which is supported through the regional innovation fund.

For this project, we intend to work with two neonatal networks and in community/labour ward settings across the region to implement best practice.

We will use a flexible, needs-based and multi-faceted package, underpinned by evidence-based innovation and education to create sustainable change. The focus will be on:
✲ Evidence-based innovation and change
✲ Increasing breastfeeding and skin-to-skin care in neonatal units
✲ Improving quality of care and decreasing inappropriate interventions in admission in labour
✲ Safeguarding vulnerable babies and childbearing women through promoting maternal-infant attachment and improving quality of care
✲ Improving women’s experiences
✲ Introducing multidisciplinary staff education.

Our theme has a strong governance structure in place. We are supported by a multidisciplinary cross-sector advisory group, and have active sub-groups in place to examine and plan work on:
✲ Normal birth
✲ Maternal and infant nutrition
✲ Multidisciplinary education.

The sub-groups support the work of the theme, and contribute to planning processes and dissemination of information. The normal birth and nutrition sub-groups were instrumental in the consultation exercise and members of the sub-groups facilitated discussion at the regional workshops in October. They were able to use their expert knowledge and understanding of the consultation to generate debate, and gather responses and data to support the exercise. The newly formed education sub-group will work collaboratively to explore and develop creative ways of delivering innovative education packages across the region. We have broad membership across regional universities and service providers and are able to draw on expertise that includes midwifery, paediatrics and obstetrics.

We have also launched an online distance learning breastfeeding education resource. This was accessed initially by staff across Yorkshire and the Humber but it is now available nationally and internationally.

Through our work in sharing good practice, the Yorkshire and the Humber HIEC is going to have a real, long-term impact on outcomes and experiences for mothers and their families. 


For further information, contact Pauline at: pauline.holloway@york.ac.uk
For the Yorkshire and the Humber HIEC’s report go to: http://tinyurl.com/63qr24d
For further programme information, go to: http://tinyurl.com/6hfxabm

References
Darzi A. (2008) High quality care for all: NHS Next Stage Review final report. See: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085825 (accessed 16 June 2011).

National Institute for Clinical Excellence (2007) Intrapartum care – care of healthy women and their babies during childbirth. See: www.nice.org.uk/nicemedia/pdf/IPCNICEGuidance.pdf (accessed 16 June 2011).