Table 1 Implementation strategies
Implementation strategy | Component details: A full description of component details has been published elsewhere [31] | Timing |
|---|---|---|
Leadership and management | • Monthly meetings will be held with management from maternity services to elicit support • Service managers will be asked to distribute resources to staff and attend training sessions • Monitoring and reporting of performance measures related to the intervention | Intervention duration only |
Local clinical practice guidelines | • A service-level guideline and procedure document will detail the recommended GWG care, including assessment, brief advice, and local referral pathways • This document will be uploaded onto the health service’s policy directory, disseminated by managers to all staff via email, and hard copies will be placed in staff common areas | Intervention duration and retained after the trial |
Prompts and reminders | • Physical point-of-care prompts including stickers in the antenatal care record, and a clinic room flip chart, will be provided to prompt recommended care delivery | Intervention duration and retained after the trial |
Local opinion leaders/champions | • Project-specific clinical midwife educators (CMEs) appointed to support staff to uptake the guidelines and provide support at a one-on-one, team, and service level • Additional local antenatal clinical leaders will be engaged to provide encouragement and demonstrate required behaviours as required | Intervention duration only |
Educational meetings and materials | • Multi-mode (online and face-to-face) training will be provided to clinicians in each maternity service, facilitated by the CMEs. The staff will participate in 1–2 h of training during the intervention period. This will include lecture-style sessions, interactive sessions, case study-based sessions, and/or one-on-one sessions • Clinicians will be provided with written educational materials (hardcopy and electronic) to support the delivery of care • Provision of scales and stadiometers (including bags for transportation) to services as needed | Intervention duration and some retained after the trial |
Care delivery monitoring and feedback (including academic detailing) | • Data from both medical records and telephone surveys conducted with women who attended the antenatal services will be used to provide feedback on adherence to the agreed GWG pathway • Service managers will be supported to set care delivery goals, monitor progress, and develop action plans in response to feedback • Antenatal service managers will report, interpret, and monitor performance measures for GWG best practice • These results will be disseminated to maternity service staff through team meetings, emails, and other usual communication mechanisms • Performance measures will be built into the existing monitoring and accountability frameworks for maternity services | Intervention duration and some retained after the trial |