The Confidential Enquiry into Maternal & Child Health (CEMACH 1997) reported that there was evidence of substandard care in more than half of all maternal deaths in the UK, with a lack of multi-professional team working and communication failures identified as contributory factors.
In response to these findings, a dedicated group of health care professionals (based in maternity units in the South West of England, U.K.) developed a training package (PROMPT - PRactical Obstetric Multi-Professional Training), designed to be used locally, and to improve the outcomes for mothers and their babies during obstetric emergencies.
In 2002, the South West based multi-professional group received a research grant from the UK Department of Health, to conduct a regional randomised control trial reviewing obstetric emergencies training. The SaFE study (Simulation and Firedrill Evaluation) aimed to establish if it was more effective for staff to attend training within their own maternity units than sending them to a central Simulation Centre for training. In addition, the study aimed to determine if including teamwork training in the obstetric emergencies courses improved the team’s management even further. Eight hospitals across the South West of England participated in the SAFE study and the trial demonstrated improvements in knowledge, clinical skills and team working during simulated emergencies following training. The improvements were the same for both local and simulation centre courses, which meant that more economical local training was equally as good as expensive courses at Simulation centres.
The same multi-professional training programme was introduced at North Bristol NHS Trust and improvements were replicated in real life, with a 50% reduction in neonatal hypoxic injuries, a 70% reduction in injuries after shoulder dystocia and improvements in performance in Category 1 emergency Caesarean sections following the introduction of the training programme.
The continued development of PROMPT led to the publication of the PROMPT ‘Course in a Box’ with the assistance of the Royal College of Obstetricians and Gynaecologists (RCOG) in 2008. National recommendations for multi-professional obstetric emergencies training for all maternity staff in the UK, coupled with data demonstrating improved outcomes for mothers and their babies has led to PROMPT being adopted by most units in the UK.
Internationally, interest has grown and PROMPT training has been adopted in a number of countries outside the UK. Many of these countries have conducted their own research trials and have demonstrated similar results to those achieved at Southmead Hospital.
The group realised that in order to achieve its audacious goal of making PROMPT training available worldwide, whether that be in developed or under-resourced countries, additional funding was required. In 2011 The PROMPT Maternity Foundation (PMF) was registered in England & Wales as a Company Limited by Guarantee (Company No. 07506593) and as a charity with the Charity Commission for England & Wales (Charity No. 1140557).
The Second Edition of the PROMPT ‘Course in the Box’ (2012) has now been produced, with a series of PROMPT 2 Train the Trainers (T3) days being run by the PMF team to update existing PROMPT users and also train new users. Training in the UK is being hosted by the RCOG in London, and maternity units/institutions can send a multi-professional team of staff to the T3 Day, to gain experience and receive training materials that will enable them to run PROMPT training courses in their own unit.