The Tommy’s Clinical Decision Tool, a device for reducing the clinical impact of placental dysfunction and preterm birth : protocol for a mixed-methods early implementation evaluation study

Abstract

Background

Disparities in stillbirth and preterm birth persist even after correction for ethnicity and social deprivation, demonstrating that there is wide geographical variation in the quality of care. To address this inequity, Tommy’s National Centre for Maternity Improvement developed the Tommy’s Clinical Decision Tool, which aims to support the provision of “the right care at the right time”, personalising risk assessment and care according to best evidence. This web-based clinical decision tool assesses the risk of preterm birth and placental dysfunction more accurately than current methods, and recommends best evidenced-based care pathways in a format accessible to both women and healthcare professionals. It also provides links to reliable sources of pregnancy information for women. The aim of this study is to evaluate implementation of Tommy’s Clinical Decision Tool in four early-adopter UK maternity services, to inform wider scale-up.

Methods

The Tommy’s Clinical Decision Tool has been developed involving maternity service users and healthcare professionals in partnership. This mixed-methods study will evaluate: maternity service user and provider acceptability and experience; barriers and facilitators to implementation; reach (whether particular groups are excluded and why), fidelity (degree to which the intervention is delivered as intended), and unintended consequences. Data will be gathered over 25 months through interviews, focus groups, questionnaires and through the Tommy’s Clinical Decision Tool itself. The NASSS framework (Non-adoption or Abandonment of technology by individuals and difficulties achieving Scale-up, Spread and Sustainability) will inform data analysis.

Discussion

This paper describes the intervention, Tommy’s Clinical Decision Tool, according to TiDIER guidelines, and the protocol for the early adopter implementation evaluation study. Findings will inform future scale up.

Trial registration

This study was prospectively registered on the ISRCTN registry no. 13498237, on 31st January 2022.

Metadata

Item Type:	Article
Authors/Creators:	Carter, J. Anumba, D. https://orcid.org/0000-0003-2502-3033 Brigante, L. Burden, C. Draycott, T. Gillespie, S. Harlev-Lam, B. Judge, A. Lenguerrand, E. Sheehan, E. Thilaganathan, B. Wilson, H. Winter, C. Viner, M. Sandall, J.
Copyright, Publisher and Additional Information:	© 2022 The Author(s). Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Keywords:	Decision support; Implementation; Pregnancy; Preterm; Process evaluation; Risk assessment; Stillbirth; eHealth
Dates:	Published: 15 August 2022 Published (online): 15 August 2022 Accepted: 23 June 2022
Institution:	The University of Sheffield
Academic Units:	The University of Sheffield > Sheffield Teaching Hospitals
Depositing User:	Symplectic Sheffield
Date Deposited:	25 Aug 2022 08:19
Last Modified:	25 Aug 2022 08:19
Status:	Published
Publisher:	BioMed Central (part of Springer Nature)
Refereed:	Yes
Identification Number:	10.1186/s12884-022-04867-w
Related URLs:	PubMed URL
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:190245

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The Tommy’s Clinical Decision Tool, a device for reducing the clinical impact of placental dysfunction and preterm birth : protocol for a mixed-methods early implementation evaluation study

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