The SWIFT-M : A Paradigm Shift in Maternity Training

SWIFT-M (Skills-based, Woman & Baby centred, Innovative, Focused, Transformational- Multi-professional) training programme has been developed to overcome the flaws in current training programmesFour consecutive “Each Baby Counts” Reports produced by the Royal College of Obstetricians and Gynaecologists (RCOG) in the United Kingdom (UK) have highlighted substandard care being the contributory factor in more than 70% of babies who sustained an intra-partum related severe hypoxic ischaemic brain injury and/or died during labour or in the immediate neonatal period, and repeated confidential enquiries into maternal deaths reports in the UK have also concluded that approximately 45% of mothers who died in the UK had substandard care. These tragic, grim and ethically unacceptable findings should make us all wake up and see and feel the “Tick Box Elephant in the Obstetric Room”. The same cardiotocograph (CTG) tools with “normal, suspicious pathological” are being used in all human fetuses, expecting them to withstand the same stress for the same duration, irrespective of their clinical context in many maternity units. Moreover, massive postpartum haemorrhage (PPH) has been illogically defined as > 1.5 L for all women despite the basic knowledge acquired in medical school that women with a lower body mass index have a lower blood volume, and women with pre-existing anaemia have less tolerance for blood loss. Moreover, different definitions of PPH are illogically being used for vaginal births and caesarean sections without appreciating the fact that it is the amount of blood that is lost that determines reduced organ perfusion, and not how it is lost. These illogical recommendations which are also unfortunately promoted by some multi-professional training programmes are likely contributory factors to increasing rate of maternal deaths in the UK.The SWIFT-M training programme was developed to focus on basic foundations of clinical medicine of individualization of care and providing an evidence-based and evidence-driven clinical care through acquisition of enhanced knowledge, skills and competencies. SWIFT-M aims to rectify that current flaws and unscientific recommendations which are contributing to avoidable harm to mothers and babies relating to the interpretation of fetal heart rate changes and management of maternal and perinatal obstetric emergencies by focusing on scientific principles.It has novel tools such as PPH Clinical Tool Box, Obstetric Haemorrhage Clinical Severity Indicator (OCSI), and easy to use, logical and systematic algorithms such as HAEMOSTASIS (PPH), EMERGENCIES (Shoulder Dystocia), ECLAMPSIAA (Eclampsia) and implementation of physiological tools for interpretation of fetal heart rate changes from the NEXT GEN Physiological CTG Masterclasses as well as practical steps to address human factors which contribute to maternal and perinatal outcomes.The SWIFT-M Training aims to provide a transformational training to enable frontline clinicians providing maternity care to transform the poor clinical outcomes stemming from substandard care to excellent outcomes for mothers and their babies, by re-inventing scientific principles which underpin evidence-driven clinical care.SWIFT-M represents a paradigm shift in multi-professional training to help frontline care providers to optimise the recognition and management of maternal and fetal emergencies to safeguard women and babies from avoidable harm. Read more