Improving sustainability and patient care for women with hyperemesis gravidarum – an ambulatory approach
A project at our hospital to improve care and support for women with severe nausea and vomiting during pregnancy is being highlighted as an area of best practice to be adopted nationally.
A new ambulatory approach is already helping to improve patient experience and sustainability by streamlining processes and educating staff. This has resulted in a reduction of admissions to hospital and also reduced the length of stay for those on an in-patient ward with hyperemesis gravidarum (HG).
Our maternity team will be presenting their findings at the Green Maternity Showcase on 6 March, which is being run by The Centre for Sustainable Healthcare (CSH), Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM).
The team, led by Beth Laverick, Lead Obstetrician for Maternal Medicine, Laura Allen, Quality Improvement Lead Midwife, and Sophie Holland, Obstetric Medicine Fellow, worked with our Virtual Ward team to support patients with HG and to receive IV hydration and medications both at a timed appointment in the virtual ward hub or in the comfort of their own home. The team have also formed virtual clinics to support patients with medication and psychological support.
Following feedback from patients and the Maternity and Neonatal Voices Partnership, they also developed an educational toolkit for health professionals to provide support and guidance to pregnant women and birthing people with nausea and vomiting.
In October 2024, 22.9 bed days were taken up at NNUH for admissions with HG, which dropped to 9.8 bed days in December following the introduction of the new pathway.
Beth said: “90% of women will experience nausea and vomiting in pregnancy, there are many safe treatments available to minimise the physical, psychological and social impact, but often they are not easily accessible.”
“We have more than halved the number of bed days by reducing the number of readmissions for women with hyperemesis. We have provided education and resources to help ensure women and their families receive evidence-based advice and support at each contact. It is fantastic that there has been such good feedback over such a short period time, and we want to ensure that we build on this.”
“The nice thing is that we have developed a model that provides bespoke, personalised and patient centred care. The team are proud that service user voice has guided the development of this service.”