Origins

Identified industry need

In 2000, the Victorian Managed Insurance Authority (VMIA), the insurers of Victorian public hospitals, commissioned an expert review of nearly 400 cases of obstetric medico-legal claims in Victoria arising between 1993 and 1998. This report identified inadequate or inappropriate use of intrapartum fetal surveillance as a major contributor to the claims burden.

For more information about this report, please read the 2004 FSEP Final Report.

As a first step to improving quality of care in this setting, VMIA funded RANZCOG to develop evidence-based clinical guideline on intrapartum fetal surveillance. This guideline would ideally become an important resource for maternity care providers and facilitate standardisation of existing local education programs and the development of new resources.

Please read the current RANZCOG Intrapartum Fetal Surveillance (IFS) Clinical Guideline.

RANZCOG recognised that the development of guideline alone, unsupported by education, was unlikely to have significant impact on clinical practice. In 2003, RANZCOG sought funding to develop an education and credentialing program based on the guideline. VMIA and DHS agreed to fund a Pilot Project to assess the feasibility and acceptance of a statewide education program.

Pilot Project

The Intrapartum Fetal Surveillance Education and Credentialling (IFSE&C) Pilot Project was funded by VMIA and the Department of Human Services Victoria (DHS). RANZCOG developed the Project in collaboration with Southern Health, The Mercy Hospital for Women, The Royal Women’s Hospital, and the Victorian branch of the Australian College of Midwives Incorporated (ACMI).

At the same time, a formalised survey of senior medical and midwifery staff in all Victorian hospitals was undertaken to map current education and assessment practices in fetal surveillance. This revealed important deficiencies in the provision and quality of fetal surveillance education, particularly in smaller or rural hospitals.

For more information regarding this survey, please read the publication A Survey of Intrapartum Fetal Surveillance Education Practices.

Ten Victorian public hospitals participated in the pilot sessions throughout 2004 to trial the format, content and delivery of education. Each five-hour face-to-face session included PowerPoint presentations, case study discussions, formative and summative testing. The response to the education was very positive and the Pilot Project was deemed a success. It was decided that there was sufficient demand for statewide delivery of the education program.

Growth of the program

In 2005, the IFSE&C Pilot Project was evaluated and renamed the Fetal Surveillance Education Program (FSEP). Again VMIA and DHS were instrumental in funding the program with support from RANZCOG.

Building on the strengths of the Pilot Project, and on the survey results, the FSEP continued to present face-to-face education in a multidisciplinary format. Educational material was refined and the program structure streamlined. Workshop and case study time was also increased to facilitate greater discussion.

While the delivery of education was focused on Victorian public hospitals, demand for the program was such that private hospitals, interstate and international sessions were soon added. The program was also offered free to the six Victorian Universities offering undergraduate and post graduate midwifery training.

During 2005, FSEP educated over 2,000 participants and over 80% of Victoria ‘s public and private hospitals. The program’s achievements during 2005 are detailed in the 2005 FSEP Annual Report.

Where we are now

Following the successful uptake of FSEP in 2005, the program continues to grow throughout Australia and New Zealand. FSEP also delivers its education in Ireland and in the Pacific Islands. We are continually adding new educational resources to respond to the industry’s educational needs. Funding from VMIA and DHS has concluded, but FSEP continues to provide its valuable education in a not for profit manner.