Inner setting
PRETERM BIRTH
Local documents reported that the hospital had quality improvement processes in place (e.g. sharing on maternity key performance indicators, staff survey results) and its vision and mission statement included three key principles underpinning the care delivered at every stage of their maternity pathway: informed choice, accessibility and continuity of care [Interviews with HCPs and analysis of local documents found a lack of research culture in the maternity services and the need for innovation was recognised. Thus, the organisation mandated a change by highlighting in the maternity services specification report their formal commitment to deliver high quality continuity of care for women and started organisational changes (e.g. layout change of several rooms to provide a small office space for the team, new equipment). The implementation of POPPIE meant the hospital became actively engaged in maternal health research and started to participate in clinical trials in collaboration with other sites. At the same time the trial was being set up, a preterm surveillance clinic was also being established as the main obstetric care pathway for women identified at risk of preterm birth and this could have improved clinical management and quality of care for the study population.