Driven by the growing independent evidence base underpinning a Totally Unique approach, diverse clinical teams continue to innovate with Flo, adapting and adopting her as an integral tool, to help their patients to self manage better.
Maternity continues to be an area of creative innovation with clinicians inspired to integrate Flo into new pathways beyond their primary implementation; since 2012 patients supported by Flo within maternity pathways has increased steadily and in 2016 we saw almost a 20 times increase in use of Flo than in 2012!
Pregnancy Induced Hypertension (PIH) and Gestational Diabetes Mellitus (GDM)
In 2012, Flo’s support was focused towards mums-to-be diagnosed with either pregnancy induced hypertension (PIH) or gestational diabetes mellitus (GDM) with organisations in the North East delivering compelling evidence that Flo’s integration has been beneficial for staff, and most importantly patients.
Patients reported:
- Feeling more in control of their condition.
- Reduced anxiety due to knowledge of baby’s wellbeing.
- High levels of satisfaction and ease of use using Flo.
- Women who had previously developed PIH during previous pregnancies stated that their latest pregnancy experience, supported by Flo, was ‘better’ compared to previous before.
Clinical Outcomes:
- Where Flo was used in GDM pathways, clinicians found that fewer babies were being born in extreme weight percentiles, and pregnancies were lasting longer where they may have previously been induced due to complications of GDM.
- For use with PIH, Flo’s notifications as a result of increased symptoms resulted in appropriate admission of patients, who subsequently had labour induced. Both mothers and babies kept healthy and safe as a result.
Cost Effectiveness:
Based on Sunderland City Hospital’s pilot project using Flo for PIH & GDM, some estimated cost savings were calculated by the team. These were done by comparing the treatment and contact Flo patients received, compared to the normal non-Flo care pathway (for example number of appointments etc.).
- For PIH, based on a cohort of 79 patients, predicted savings of £7,745.82 could be made over the course of pregnancy (£40,002 non-Flo, £32,256.18 with Flo).
- For GDM, based on a cohort of 119 patients, predicted savings of £11,624.73 could be made over the course of pregnancy (£153,189.99 non-Flo, £141,565.26 with Flo).
- In addition to this, fewer appointments with patients will free up time for clinicians and improve capacity.
Positive patient and clinical outcomes were supported City Hospitals Sunderland’s 2014 CQC visit who cited the application of Flo to support the GDM pathway as an area of outstanding practice. These successful pathways spread further across the North East region to South Tees NHS Foundation Trust, the West Cumbria Antenatal Services, Newcastle-upon-Tyne Hospital and Gateshead. The proven pathways then spread even further to the University Hospital of North Midlands, Poole and Bournemouth NHS Trust, who have recently begun supporting mums to be with PIH during pregnancy via Flo. While Great Western Hospitals are also accessing similar best practice PIH protocols moving forward.
The West Cumbria Antenatal Service have delivered some solid outcomes from their implementation of Flo within their outpatient pathway supporting mums to be with type 1 diabetes, or those who develop GDM:
- 15% reduction in preterm deliveries in type 1 diabetic pregnancies.
- 25% reduction of macrosomia in type 1 diabetic pregnancies.
- 8% reduction of macrosomia in pregnancies with GDM.
- 20% reduction in cesarean sections in type 1 diabetic pregnancies.
- 34% improvement in achieving HbA1c targets at 28 weeks.
As well as great clinician outcomes, patient feedback was also positive:
- 90% of respondents found Flo to be beneficial for managing diabetes during pregnancy.
- 90% of respondents found Flo’s advice messages useful.
- 90% of respondents would recommend using Flo to others.
- 100% of respondents found Flo easy to use.
More Clinical Innovation: Moving forwards into 2017, the number of maternity pathways supported via Flo continued to diversify:
Breastfeeding support
Similar to PIH and GDM, Flo’s development towards supporting mums with breastfeeding emerged from an innovative pathway developed in the North East, and recognising the impact has now been adopted in other maternity units across the country, increasing the number of patients supported; emerging as the 2nd most commonly accessed maternity pathway.
Outcomes reported by mums of improved reassurance and support but that those supported by Flo for breastfeeding support were more likely to continue breastfeeding at 6 weeks when compared to those mums without Flo’s intervention.
Lauren, a new Mum who hoped to breastfeed her baby featured in the award winning “The Power of People” video, commissioned by The Health Foundation to highlight the impact of 5 successful innovations.
More information around breastfeeding support pathways here.
Type 2 Diabetes in Pregnancy
Sandwell and West Birmingham Hospitals are developing an innovative pathway for mums-to-be already diagnosed with type 2 diabetes pre-natally. The pathway reinforces support to self manage whilst receiving a new treatment regimes due to pregnancy and offers opportunities of timely intervention and reassurance for mums to be outside of the traditional clinic environment aiming to deliver improved clinical outcomes and more efficient use of capacity.
Scottish Health Boards have embraced the opportunity to support women pre and postnatally and have developed a range of emerging new pathways, below.
- Foetal movement monitoring
Pathways helping mums become more aware of their baby’s movements during pregnancy, improving awareness of their own daily movements and what normal level of movement is to be expected; and if necessary who to contact and when to support intervention.
- Perinatal, postnatal and antenatal care for mums and their babies
Pathways supporting new parents and their babies. Flo offers relevant, timely advice and guidance to support parents and their babies in having the best start in life.
- Smoking cessation
Pathways adapted from best practice smoking cessation design, tailored towards key techniques helping expectant mums quit smoking.
For more information on integrating Flo within maternity services please contact lisa.taylor@simple.uk.net
#Pregnancy Induced Hypertension #Gestational Diabetes Mellitus #TotallyUnique
