TAKING STOCK: THE AUSTRALASIAN MATERNITY OUTCOMES SURVEILLANCE SYSTEM (AMOSS) FIVE YEARS ON As we enter into the sixth year of the AMOSS surveillance and research system, it’s timely to review where we are and what has changed. Fittingly, AMOSS was launched at Parliament House Canberra in 2009 - the same year as the Improving Maternity Services in Australia Maternity Services Review Report was released. Against the backdrop of some of the most significant changes that have occurred in Australian maternity care, where does AMOSS fit? AMOSS objectives are closely aligned to key recommendations of the Maternity Services Review report, which urged improved national data collection on maternal morbidity. AMOSS has achieved this for select, specific rare and severe conditions but only because of the support of the wider maternity community, RANZCOG, ACM and SOMANZ In our work to streamline quality data collection AMOSS has forged strong networks to support quality data collection. Our advisory groups provide critical formal avenues for dialogue and consultation. The bedrock of our study remains our AMOSS site coordinators - midwives and obstetricians, maternal-fetal specialists and many others - who provide data to and consultation with AMOSS. Of course, AMOSS is one part of a critical nexus of initiatives that work to improve maternity care in Australia and New Zealand. We have been guided by and worked closely with Australian jurisdictional maternal and perinatal committees and Colleges. Our partnership with New Zealand under the auspices of the Perinatal and Maternal Mortality Review Committee (PMMRC) has provided another critical dimension to the system. However, another dimension to the AMOSS networks is a strengthening of collaboration across disciplines. The Maternity Services Review Report called for “guidelines to support collaborative multidisciplinary care”. In our efforts to collect data on serious events in pregnancy, we have needed to expand beyond perinatal data capture systems to ensure optimal surveillance and quality data. For instance, in the rheumatic heart disease study, RHD Control Register teams and cardiac care now work with AMOSS coordinators to ensure women are included on our study. In 2013 a data item was included on the Australia and New Zealand Breast Surgeons Quality Audit, and networks are being formed with groups such as Breast Cancer Network Australia and Breast Cancer Nurses to ensure women are included in our study. There is recognition that good data must include perspectives of the women who experience these conditions: our recent studies include a qualitative component, and our advisory groups benefit from the input of women who are impacted by serious morbidity in pregnancy. The system created by AMOSS has created its own challenges! As we have grown, the data collection system has outgrown itself and we anticipate ‘AMOSS Mark II’ to be fully released by mid-year, which will – apart from providing a more robust system – will give better reporting to hospitals. Data analysis in progress for several of our studies will provide our findings back to those who care for women who experience these rare and often devastating conditions in pregnancy. AMOSS has an important educational role, both direct and indirect. The inclusion of specific conditions raises awareness, and the process of data collection supports specific knowledge – acknowledged in CPD points for midwives, provided by the Australian College of Midwives. More broadly, it fosters a better awareness of the overall burden of morbidity in maternity settings. Once again, we would like to acknowledge and celebrate that AMOSS is a national maternity collaboration which in itself is an achievement. It is due to the enthusiasm and drive of maternity and other health care disciplines in their efforts to make a difference and improve care of women during pregnancy that AMOSS continues. Professor Elizabeth Sullivan Principal Investigator Newsletter 21 - April 2014
Transcript
TAKING STOCK: THE AUSTRALASIAN MATERNITY OUTCOMES SURVEILLANCE SYSTEM (AMOSS) FIVE YEARS ON
As we enter into the sixth year of the AMOSS surveillance and research system, it’s timely to review where we are and what has changed.
Fittingly, AMOSS was launched at Parliament House Canberra in 2009 - the same year as the Improving Maternity Services in Australia Maternity Services Review Report was released.
Against the backdrop of some of the most significant changes that have occurred in Australian maternity care, where does AMOSS fit? AMOSS objectives are closely aligned to key recommendations of the Maternity Services Review report, which urged improved national data collection on maternal morbidity. AMOSS has achieved this for select, specific rare and severe conditions but only because of the support of the wider maternity community, RANZCOG, ACM and SOMANZ
In our work to streamline quality data collection AMOSS has forged strong networks to support quality data collection. Our advisory groups provide critical formal avenues for dialogue and consultation. The bedrock of our study remains our AMOSS site coordinators - midwives and obstetricians, maternal-fetal specialists and many others - who provide data to and consultation with AMOSS. Of course, AMOSS is one part of a critical nexus of initiatives that work to improve maternity care in Australia and New Zealand.
We have been guided by and worked closely with Australian jurisdictional maternal and perinatal committees and Colleges. Our partnership with New Zealand under the auspices of the Perinatal and Maternal Mortality Review Committee (PMMRC) has provided another critical dimension to the system. However, another dimension to the AMOSS networks is a strengthening of collaboration across disciplines. The Maternity Services Review Report called for “guidelines to support collaborative multidisciplinary care”. In our efforts to collect data on serious events in pregnancy, we have needed to expand beyond perinatal data capture systems to ensure optimal surveillance and quality data. For instance, in the rheumatic heart disease study, RHD Control Register teams and cardiac care now work with AMOSS coordinators to ensure women are included on our study. In 2013 a data item was included on the Australia and New Zealand Breast Surgeons Quality Audit, and networks are being formed with groups such as Breast Cancer Network Australia and Breast Cancer Nurses to ensure women are included in our study. There is recognition that good data must include perspectives of the women who experience these conditions: our recent studies include a qualitative component, and our advisory groups benefit from the input of women who are impacted by serious morbidity in pregnancy.
The system created by AMOSS has created its own challenges! As we have grown, the data collection system has outgrown itself and we anticipate ‘AMOSS Mark II’ to be fully released by mid-year, which will – apart from providing a more robust system – will give better reporting to hospitals. Data analysis in progress for several of our studies will provide our findings back to those who care for women who experience these rare and often devastating conditions in pregnancy.
AMOSS has an important educational role, both direct and indirect. The inclusion of specific conditions raises awareness, and the process of data collection supports specific knowledge – acknowledged in CPD points for midwives, provided by the Australian College of Midwives. More broadly, it fosters a better awareness of the overall burden of morbidity in maternity settings.
Once again, we would like to acknowledge and celebrate that AMOSS is a national maternity collaboration which in itself is an achievement. It is due to the enthusiasm and drive of maternity and other health care disciplines in their efforts to make a difference and improve care of women during pregnancy that AMOSS continues.
Professor Elizabeth Sullivan Principal Investigator
Newsletter 21 - April 2014
Thanks to the following hospitals that have responded to AMOSS over the last three months
All three months Albany Regional Hospital Alice Springs Hospital Angliss Hospital Ararat Campus Armadale Health Service Armidale Hospital Ashford Hospital Atherton Tableland Hospital Auburn Hospital Auckland City Hospital Ayr Hospital Bairnsdale Regional Health Service Ballarat Health Services Bankstown-Lidcombe Hospital Bathurst Base Hospital Bay of Plenty DHB Bega Hospital Benalla & District Memorial Hospital Bendigo Health Care Group Bentley Health Service Biloela Hospital Blacktown Hospital Bowral Hospital Box Hill Hospital Bridgetown District Hospital Broken Hill Health Service Broome District Hospital Bunbury Regional Hospital Bundaberg Hospital Burnside War Memorial Hospital Busselton District Hospital Caboolture Hospital Cairns Base Hospital Cairns Private Hospital Calvary Health Care Calvary Health Care ACT Calvary Health Care Riverina Campbelltown Hospital Canterbury Hospital Casino Hospital Central Gippsland Health Service Charleville Hospital Chinchilla Hospital Christchurch Women’s Hospital Coffs Harbour Base Hospital Cohuna District Hospital Colac Area Health Collie District Hospital Cooma Hospital Cootamundra Hospital Cowra Health Service Dandenong Hospital Deniliquin Hospital Derby Regional Health Djerriwarrh Health Services Dubbo Base Hospital Dunedin Hospital Echuca Regional Health Emerald Hospital Esperance District Hospital Fairfield Hospital Figtree Private Hospital Flinders Medical Centre Flinders Private Hospital Forbes Hospital Frances Perry House Frankston Hospital Gawler Health Service Geraldton Regional Hospital Gippsland Southern Health Service Gisborne Hospital Gladstone Hospital Glen Innes Hospital Glengarry Private Hospital Gold Coast Hospital Goondiwindi Hospital Gosford Hospital Goulburn Base Hospital Gove District Hospital East Arnhem Grafton Base Hospital Gympie Hospital Hawke’s Bay Hospital Hawkesbury District Health Service Hervey Bay Hospital Hobart Private Hospital Hornsby Ku-ring-gai Hospital Hurstville Private Hospital Innisfail Hospital Inverell Health Service Jessie McPherson Private Hospital John Flynn Gold Coast Private Hospital Kaleeya Hospital Kapunda Hospital Kareena Private Hospital Katanning District Hospital
Katherine Hospital Kerang & District Hospital King Edward Memorial Hospital For Women Kingaroy Hospital Kununurra District Hospital Kyabram District Health Service Latrobe Regional Hospital Launceston General Hospital Lismore Base Hospital Liverpool Hospital Logan Hospital Longreach Hospital Loxton Hospital Complex Lyell McEwin Hospital Mackay Base Hospital Manning Base Hospital Mansfield District Hospital Mareeba Hospital Margaret River District Hospital Maryborough District Health Service Mater Misericordiae Hospital Rockhampton Mater Mothers Hospital Brisbane Mater Private Hospital Redland Mercy Hospital for Women Mercy Hospital Mount Lawley Middlemore Hospital Mildura Base Hospital Milton-Ulladulla Hospital Mitcham Private Hospital Monash Birth Centre Moree Hospital Moruya District Hospital Mount Barker and Districts Soldiers Memorial Hospital Mount Gambier & District Health Services Mount Isa Hospital Mt Waverley Private Hospital Mudgee District Hospital Mullumbimby Hospital Murray Bridge Soldiers' Memorial Hospital Inc Murwillumbah District Hospital Muswellbrook District Hospital Nambour General Naracoorte Health Services Narrabri Hospital Narrandera Hospital Narrogin Regional Hospital Nelson Hospital Nepean Hospital Nepean Private Hospital Newcastle Private Hospital North Eastern Community Hospital North Gosford Private Hospital North Shore Private Hospital North West Private Hospital Burnie Campus Northam Regional Hospital Northeast Health Wangaratta Northern Beaches Maternity Services Northpark Private Hospital Norwest Private Hospital Orange Base Hospital Osborne Park Hospital Parkes Hospital Peel Health Campus Pindara Private Hospital Port Augusta Hospital & Regional Health Services Port Macquarie Base Hospital Port Pirie Regional Health Service Portland District Health Proserpine Hospital Queanbeyan District Hospital & Health Service Redland Hospital Riverland Regional Health Service Rockhampton Hospital Rockingham General Hospital Roma Hospital Royal Brisbane and Women's Hospital Royal Darwin Hospital Royal Hobart Hospital Royal Hospital for Women Royal North Shore Hospital (RNSH) Royal Prince Alfred Hospital (RPAH) Ryde Hospital Sandringham Hospital Scott Memorial Hospital Shoalhaven District Memorial Hospital South Coast District Hospital South Gippsland Hospital (Foster) South West Health Care (Camperdown) Southern Flinders Health - Crystal Brook Campus Southland Hospital St Andrew’s Ipswich Private Hospital St George Hospital St John of God Geelong St John of God Geraldton St John of God Health Care Ballarat
St John of God Health Care Berwick St John of God Health Care Bunbury St John of God Health Care Subiaco St John of God Hospital Bendigo St John of God Hospital Murdoch St Vincents Private Hospital Stanthorpe Hospital Stawell Regional Health Sunshine Hospital Sutherland Hospital Swan Hill District Hospital Swan Kalamunda Health Service Sydney Adventist Hospital Sydney Southwest Private Hospital Tamworth Rural Referral Hospital Tanunda Hospital Taranaki Base Hospital Temora District Hospital The Bays Hospital Mornington The Canberra Hospital The Kilmore & District Hospital The Mater Hospital Sydney The Royal Women's Hospital The Sunshine Coast Private Hospital The Wesley Hospital The Whyalla Hospital & Health Services Thursday Island Hospital Timaru Hospital Townsville Hospital WA Country Health Service - Goldfields Wagga Wagga Base Hospital Waikato Hospital Waikerie Health Services Wairarapa Hospital Wallaroo Hospital Warwick Hospital Werribee Mercy Hospital West Gippsland Hospital Westmead Hospital Whanganui Hospital Whangarei Hospital Wimmera Health Care Group (Horsham) Wollongong Hospital Women's and Children's Hospital, Adelaide Wonthaggi Hospital (Bass Coast Regional Health) Wyong Hospital Yarrawonga District Health Service Young Hospital Two months Albury Wodonga Health Attadale Private Hospital Carnarvon Regional Hospital Casey Hospital Dalby Hospital Darwin Private Hospital Epworth Freemasons Hospital Gladstone Mater Hospital Griffith Base Hospital Gunnedah Hospital Hutt Valley Hospital Joondalup Health Campus Kalgoorlie Regional Hospital Kempsey District Hospital Macksville Hospital Palmerston North Hospital Port Lincoln Health Services Inc Redcliffe Hospital Rotorua Hospital Singleton District Hospital South West Health Care (Warrnambool) St George Hospital Queensland St George Private Hospital St Vincent's & Mercy Private Hospital The Northern Hospital The Tweed Hospital Toowoomba Base Hospital Tumut Hospital Westmead Private Hospital One month Calvary Health Private Goulburn Valley Health Peninsula Private Hospital Sunnybank Private Hospital Wellington Hospital
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Thanks to the following hospitals that have responded to AMOSS over the last three months
All three months Albany Regional Hospital Alice Springs Hospital Angliss Hospital Ararat Campus Armadale Health Service Armidale Hospital Ashford Hospital Atherton Tableland Hospital Auburn Hospital Auckland City Hospital Ayr Hospital Bairnsdale Regional Health Service Ballarat Health Services Bankstown-Lidcombe Hospital Bathurst Base Hospital Bay of Plenty DHB Bega Hospital Benalla & District Memorial Hospital Bendigo Health Care Group Bentley Health Service Biloela Hospital Blacktown Hospital Bowral Hospital Box Hill Hospital Bridgetown District Hospital Broken Hill Health Service Broome District Hospital Bunbury Regional Hospital Bundaberg Hospital Burnside War Memorial Hospital Busselton District Hospital Caboolture Hospital Cairns Base Hospital Cairns Private Hospital Calvary Health Care Calvary Health Care ACT Calvary Health Care Riverina Campbelltown Hospital Canterbury Hospital Casino Hospital Central Gippsland Health Service Charleville Hospital Chinchilla Hospital Christchurch Women’s Hospital Coffs Harbour Base Hospital Cohuna District Hospital Colac Area Health Collie District Hospital Cooma Hospital Cootamundra Hospital Cowra Health Service Dandenong Hospital Deniliquin Hospital Derby Regional Health Djerriwarrh Health Services Dubbo Base Hospital Dunedin Hospital Echuca Regional Health Emerald Hospital Esperance District Hospital Fairfield Hospital Figtree Private Hospital Flinders Medical Centre Flinders Private Hospital Forbes Hospital Frances Perry House Frankston Hospital Gawler Health Service Geraldton Regional Hospital Gippsland Southern Health Service Gisborne Hospital Gladstone Hospital Glen Innes Hospital Glengarry Private Hospital Gold Coast Hospital Goondiwindi Hospital Gosford Hospital Goulburn Base Hospital Gove District Hospital East Arnhem Grafton Base Hospital Gympie Hospital Hawke’s Bay Hospital Hawkesbury District Health Service Hervey Bay Hospital Hobart Private Hospital Hornsby Ku-ring-gai Hospital Hurstville Private Hospital Innisfail Hospital Inverell Health Service Jessie McPherson Private Hospital John Flynn Gold Coast Private Hospital Kaleeya Hospital Kapunda Hospital Kareena Private Hospital Katanning District Hospital
Katherine Hospital Kerang & District Hospital King Edward Memorial Hospital For Women Kingaroy Hospital Kununurra District Hospital Kyabram District Health Service Latrobe Regional Hospital Launceston General Hospital Lismore Base Hospital Liverpool Hospital Logan Hospital Longreach Hospital Loxton Hospital Complex Lyell McEwin Hospital Mackay Base Hospital Manning Base Hospital Mansfield District Hospital Mareeba Hospital Margaret River District Hospital Maryborough District Health Service Mater Misericordiae Hospital Rockhampton Mater Mothers Hospital Brisbane Mater Private Hospital Redland Mercy Hospital for Women Mercy Hospital Mount Lawley Middlemore Hospital Mildura Base Hospital Milton-Ulladulla Hospital Mitcham Private Hospital Monash Birth Centre Moree Hospital Moruya District Hospital Mount Barker and Districts Soldiers Memorial Hospital Mount Gambier & District Health Services Mount Isa Hospital Mt Waverley Private Hospital Mudgee District Hospital Mullumbimby Hospital Murray Bridge Soldiers' Memorial Hospital Inc Murwillumbah District Hospital Muswellbrook District Hospital Nambour General Naracoorte Health Services Narrabri Hospital Narrandera Hospital Narrogin Regional Hospital Nelson Hospital Nepean Hospital Nepean Private Hospital Newcastle Private Hospital North Eastern Community Hospital North Gosford Private Hospital North Shore Private Hospital North West Private Hospital Burnie Campus Northam Regional Hospital Northeast Health Wangaratta Northern Beaches Maternity Services Northpark Private Hospital Norwest Private Hospital Orange Base Hospital Osborne Park Hospital Parkes Hospital Peel Health Campus Pindara Private Hospital Port Augusta Hospital & Regional Health Services Port Macquarie Base Hospital Port Pirie Regional Health Service Portland District Health Proserpine Hospital Queanbeyan District Hospital & Health Service Redland Hospital Riverland Regional Health Service Rockhampton Hospital Rockingham General Hospital Roma Hospital Royal Brisbane and Women's Hospital Royal Darwin Hospital Royal Hobart Hospital Royal Hospital for Women Royal North Shore Hospital (RNSH) Royal Prince Alfred Hospital (RPAH) Ryde Hospital Sandringham Hospital Scott Memorial Hospital Shoalhaven District Memorial Hospital South Coast District Hospital South Gippsland Hospital (Foster) South West Health Care (Camperdown) Southern Flinders Health - Crystal Brook Campus Southland Hospital St Andrew’s Ipswich Private Hospital St George Hospital St John of God Geelong St John of God Geraldton St John of God Health Care Ballarat
St John of God Health Care Berwick St John of God Health Care Bunbury St John of God Health Care Subiaco St John of God Hospital Bendigo St John of God Hospital Murdoch St Vincents Private Hospital Stanthorpe Hospital Stawell Regional Health Sunshine Hospital Sutherland Hospital Swan Hill District Hospital Swan Kalamunda Health Service Sydney Adventist Hospital Sydney Southwest Private Hospital Tamworth Rural Referral Hospital Tanunda Hospital Taranaki Base Hospital Temora District Hospital The Bays Hospital Mornington The Canberra Hospital The Kilmore & District Hospital The Mater Hospital Sydney The Royal Women's Hospital The Sunshine Coast Private Hospital The Wesley Hospital The Whyalla Hospital & Health Services Thursday Island Hospital Timaru Hospital Townsville Hospital WA Country Health Service - Goldfields Wagga Wagga Base Hospital Waikato Hospital Waikerie Health Services Wairarapa Hospital Wallaroo Hospital Warwick Hospital Werribee Mercy Hospital West Gippsland Hospital Westmead Hospital Whanganui Hospital Whangarei Hospital Wimmera Health Care Group (Horsham) Wollongong Hospital Women's and Children's Hospital, Adelaide Wonthaggi Hospital (Bass Coast Regional Health) Wyong Hospital Yarrawonga District Health Service Young Hospital Two months Albury Wodonga Health Attadale Private Hospital Carnarvon Regional Hospital Casey Hospital Dalby Hospital Darwin Private Hospital Epworth Freemasons Hospital Gladstone Mater Hospital Griffith Base Hospital Gunnedah Hospital Hutt Valley Hospital Joondalup Health Campus Kalgoorlie Regional Hospital Kempsey District Hospital Macksville Hospital Palmerston North Hospital Port Lincoln Health Services Inc Redcliffe Hospital Rotorua Hospital Singleton District Hospital South West Health Care (Warrnambool) St George Hospital Queensland St George Private Hospital St Vincent's & Mercy Private Hospital The Northern Hospital The Tweed Hospital Toowoomba Base Hospital Tumut Hospital Westmead Private Hospital One month Calvary Health Private Goulburn Valley Health Peninsula Private Hospital Sunnybank Private Hospital Wellington Hospital
Thanks to the following hospitals that have responded to AMOSS over the last three months
All three months Albany Regional Hospital Alice Springs Hospital Angliss Hospital Ararat Campus Armadale Health Service Armidale Hospital Ashford Hospital Atherton Tableland Hospital Auburn Hospital Auckland City Hospital Ayr Hospital Bairnsdale Regional Health Service Ballarat Health Services Bankstown-Lidcombe Hospital Bathurst Base Hospital Bay of Plenty DHB Bega Hospital Benalla & District Memorial Hospital Bendigo Health Care Group Bentley Health Service Biloela Hospital Blacktown Hospital Bowral Hospital Box Hill Hospital Bridgetown District Hospital Broken Hill Health Service Broome District Hospital Bunbury Regional Hospital Bundaberg Hospital Burnside War Memorial Hospital Busselton District Hospital Caboolture Hospital Cairns Base Hospital Cairns Private Hospital Calvary Health Care Calvary Health Care ACT Calvary Health Care Riverina Campbelltown Hospital Canterbury Hospital Casino Hospital Central Gippsland Health Service Charleville Hospital Chinchilla Hospital Christchurch Women’s Hospital Coffs Harbour Base Hospital Cohuna District Hospital Colac Area Health Collie District Hospital Cooma Hospital Cootamundra Hospital Cowra Health Service Dandenong Hospital Deniliquin Hospital Derby Regional Health Djerriwarrh Health Services Dubbo Base Hospital Dunedin Hospital Echuca Regional Health Emerald Hospital Esperance District Hospital Fairfield Hospital Figtree Private Hospital Flinders Medical Centre Flinders Private Hospital Forbes Hospital Frances Perry House Frankston Hospital Gawler Health Service Geraldton Regional Hospital Gippsland Southern Health Service Gisborne Hospital Gladstone Hospital Glen Innes Hospital Glengarry Private Hospital Gold Coast Hospital Goondiwindi Hospital Gosford Hospital Goulburn Base Hospital Gove District Hospital East Arnhem Grafton Base Hospital Gympie Hospital Hawke’s Bay Hospital Hawkesbury District Health Service Hervey Bay Hospital Hobart Private Hospital Hornsby Ku-ring-gai Hospital Hurstville Private Hospital Innisfail Hospital Inverell Health Service Jessie McPherson Private Hospital John Flynn Gold Coast Private Hospital Kaleeya Hospital Kapunda Hospital Kareena Private Hospital Katanning District Hospital
Katherine Hospital Kerang & District Hospital King Edward Memorial Hospital For Women Kingaroy Hospital Kununurra District Hospital Kyabram District Health Service Latrobe Regional Hospital Launceston General Hospital Lismore Base Hospital Liverpool Hospital Logan Hospital Longreach Hospital Loxton Hospital Complex Lyell McEwin Hospital Mackay Base Hospital Manning Base Hospital Mansfield District Hospital Mareeba Hospital Margaret River District Hospital Maryborough District Health Service Mater Misericordiae Hospital Rockhampton Mater Mothers Hospital Brisbane Mater Private Hospital Redland Mercy Hospital for Women Mercy Hospital Mount Lawley Middlemore Hospital Mildura Base Hospital Milton-Ulladulla Hospital Mitcham Private Hospital Monash Birth Centre Moree Hospital Moruya District Hospital Mount Barker and Districts Soldiers Memorial Hospital Mount Gambier & District Health Services Mount Isa Hospital Mt Waverley Private Hospital Mudgee District Hospital Mullumbimby Hospital Murray Bridge Soldiers' Memorial Hospital Inc Murwillumbah District Hospital Muswellbrook District Hospital Nambour General Naracoorte Health Services Narrabri Hospital Narrandera Hospital Narrogin Regional Hospital Nelson Hospital Nepean Hospital Nepean Private Hospital Newcastle Private Hospital North Eastern Community Hospital North Gosford Private Hospital North Shore Private Hospital North West Private Hospital Burnie Campus Northam Regional Hospital Northeast Health Wangaratta Northern Beaches Maternity Services Northpark Private Hospital Norwest Private Hospital Orange Base Hospital Osborne Park Hospital Parkes Hospital Peel Health Campus Pindara Private Hospital Port Augusta Hospital & Regional Health Services Port Macquarie Base Hospital Port Pirie Regional Health Service Portland District Health Proserpine Hospital Queanbeyan District Hospital & Health Service Redland Hospital Riverland Regional Health Service Rockhampton Hospital Rockingham General Hospital Roma Hospital Royal Brisbane and Women's Hospital Royal Darwin Hospital Royal Hobart Hospital Royal Hospital for Women Royal North Shore Hospital (RNSH) Royal Prince Alfred Hospital (RPAH) Ryde Hospital Sandringham Hospital Scott Memorial Hospital Shoalhaven District Memorial Hospital South Coast District Hospital South Gippsland Hospital (Foster) South West Health Care (Camperdown) Southern Flinders Health - Crystal Brook Campus Southland Hospital St Andrew’s Ipswich Private Hospital St George Hospital St John of God Geelong St John of God Geraldton St John of God Health Care Ballarat
St John of God Health Care Berwick St John of God Health Care Bunbury St John of God Health Care Subiaco St John of God Hospital Bendigo St John of God Hospital Murdoch St Vincents Private Hospital Stanthorpe Hospital Stawell Regional Health Sunshine Hospital Sutherland Hospital Swan Hill District Hospital Swan Kalamunda Health Service Sydney Adventist Hospital Sydney Southwest Private Hospital Tamworth Rural Referral Hospital Tanunda Hospital Taranaki Base Hospital Temora District Hospital The Bays Hospital Mornington The Canberra Hospital The Kilmore & District Hospital The Mater Hospital Sydney The Royal Women's Hospital The Sunshine Coast Private Hospital The Wesley Hospital The Whyalla Hospital & Health Services Thursday Island Hospital Timaru Hospital Townsville Hospital WA Country Health Service - Goldfields Wagga Wagga Base Hospital Waikato Hospital Waikerie Health Services Wairarapa Hospital Wallaroo Hospital Warwick Hospital Werribee Mercy Hospital West Gippsland Hospital Westmead Hospital Whanganui Hospital Whangarei Hospital Wimmera Health Care Group (Horsham) Wollongong Hospital Women's and Children's Hospital, Adelaide Wonthaggi Hospital (Bass Coast Regional Health) Wyong Hospital Yarrawonga District Health Service Young Hospital Two months Albury Wodonga Health Attadale Private Hospital Carnarvon Regional Hospital Casey Hospital Dalby Hospital Darwin Private Hospital Epworth Freemasons Hospital Gladstone Mater Hospital Griffith Base Hospital Gunnedah Hospital Hutt Valley Hospital Joondalup Health Campus Kalgoorlie Regional Hospital Kempsey District Hospital Macksville Hospital Palmerston North Hospital Port Lincoln Health Services Inc Redcliffe Hospital Rotorua Hospital Singleton District Hospital South West Health Care (Warrnambool) St George Hospital Queensland St George Private Hospital St Vincent's & Mercy Private Hospital The Northern Hospital The Tweed Hospital Toowoomba Base Hospital Tumut Hospital Westmead Private Hospital One month Calvary Health Private Goulburn Valley Health Peninsula Private Hospital Sunnybank Private Hospital Wellington Hospital
NewAs sommonthgrant AMOSand inwere and canew sand dshouldsystemadditi
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system) will . A ar with its Open cases you to click rectly into plete the
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tions will be ve.
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NZ) for ails and orth West who has o the AMOSS
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s data collector ad down and hanfour years the t
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AMOSS Team Nasrin Javid, AMOSS Project Coordinator, UNSW Medicine Michele Partridge, UNSW Medicine Tel 02 9382 1068 E [email protected] URL: www.amoss.com.au
NZ Coordinator Vicki Masson Tel 09 923 4440 E [email protected] RHD Coordinators Geraldine Vaughan, UNSW Medicine Tel 02 9382 1564 E [email protected] Kylie Tune, Menzies School of Health Research Tel 0448 777780 E [email protected] Faith Mahony, Auckland City Hospital NZ Tel 09 3074949 Ex25342 E [email protected]
AMOSS Investigators Chief: Professor Elizabeth Sullivan, UNSW Medicine; Professor Michael Peek, University of Sydney; Professor Marian Knight, University of Oxford; Professor David Ellwood, Griffith University; Professor Lisa Jackson Pulver, UNSW Medicine; Professor Caroline Homer, University of Technology Sydney; Dr Claire McLintock, Auckland City Hospital, NZ; Associate: Prof Elizabeth Elliott, APSU: The Children’s Hospital Westmead; Dr Tessa Ho, Mary Aikenhead Ministries; A/Prof Nolan McDonnell, King Edward Memorial Hospital for Women, WA; Dr Wendy Pollock, La Trobe University/Mercy Hospital for Women, Victoria; A/Prof Yvonne Zurynski, APSU, The Children’s Hospital Westmead, Sydney
Gestational Breast Cancer Investigators Professor Elizabeth Sullivan, UNSW Medicine Winthrop Professor Christobel Saunders, University of Western Australia; Professor Jan Dickinson, University of Western Australia; Dr Angela Ives, University of Western Australia; Professor Jane Fisher, Monash University; Dr Greg Duncombe, Royal Brisbane Women’s Hospital; Dr Karin Hammarberg, Monash University
Massive Obstetric Haemorrhage Professor Elizabeth Sullivan, UNSW Medicine; Dr Claire McLintock, Auckland City Hospital; Dr Erica Wood, Australian Red Cross Blood Service; Dr Zoe McQuilten, Monash University; Professor David Ellwood, Griffith University; Dr Wendy Pollock, La Trobe University; A/Prof Andrew Bisits, Royal Hospital for Women; Dr Amanda Henry, UNSW Medicine
RHD Investigators Chief: Professor Elizabeth Sullivan, UNSW Medicine; Professor Lisa Jackson Pulver, UNSW Medicine; Professor Jonathan Carapetis, Telethon Institute for Child Health Research; Dr Warren Walsh, UNSW Medicine; Professor Michael Peek, University of Sydney; Dr Claire McLintock Auckland City Hospital Associate: Dr Suzanne Belton, University of Sydney; Professor Alex Brown, Baker IDI NT; A/ Professor Elizabeth Comino, UNSW Medicine; Ms Heather D’Antoine, University of Sydney; Dr Simon Kane, Lyell McEwin Hospital, Adelaide; Professor Juanita Sherwood, University of Technology Sydney; Dr Sujatha Thomas, Royal Darwin Hospital, Darwin; Dr Bo Remenyi, Menzies NT; Ms Geri Vaughan, UNSW Medicine
Vasa Praevia Investigators Professor Elizabeth Sullivan, UNSW Medicine; A/Prof Yinka Oyelese Jersey Shore University Medical Centre; A/Prof Robert Cincotta, Mater Mothers Hospital; Dr Greg Duncombe, Royal Brisbane Women’s Hospital; Professor Caroline Homer, University of Technology Sydney
Funding We gratefully acknowledge the following funding: NHMRC; [AMOSS #510298; Rheumatic heart disease (RHD) # 1024206]; National Breast Cancer Foundation [Novel Concept Award]; International Vasa Previa Foundation: [Vasa previa study]; UNSW Major Research Equipment and Infrastructure Initiative (MREII); Australian Red Cross Blood Service and Royal Hospital for Women Foundation Board: (Massive obstetric haemorrhage study)
Gestational Breast Cancer (GBC) Update The AMOSS gestational breast cancer (GBC) study has been extended until June 30th 2014, as data collection for this study has resulted in only a small number of cases reported to date. AMOSS has been working with the Breast Cancer Network Australia (BCNA) to enhance data collection and capture women who have been diagnosed with breast cancer whilst pregnant. In the latest edition of the Beacon magazine there is a half page article on the AMOSS study The BEACON magazine Issue 66
Vasa Praevia (VP) The vasa praevia (VP) study will cease data collection on April 30 2014. This worthwhile study has been the first international prospective population based study on this rare but potentially fatal condition Please continue to notify the AMOSS office if you have had a vasa praevia case occur at your hospital from April 2013 until the end of April 2014. For more information on vasa praevia: The Royal Australian and New Zealand College of Obstetricians & Gynaecologists – College Statements 2012
Rebarber, A., Dolin, C., Fox, NS., Klauser, CK., Saltzman, DH., Roman, AS. (2014). Natural history of vasa previa across gestation using a screening protocol. Journal of ultrasound in medicine, 33(1): 141-147.
New AMOSS Study for 2014 Massive Obstetric Haemorrhage (MOH) Data collection for the study of MOH will be commencing shortly. Inclusion criteria: All women who experience an obstetric haemorrhage at ≥ 20 weeks gestation, or within 24 hours postpartum and 1. Receive 5 or more units of red blood cells within 4 hours, and 2. Bleeding originates from the genital tract or uterus
Rheumatic heart disease in pregnancy We’re in our second year of data collection for the quantitative study of this condition. Thanks so much for your input! While RHD is very disproportionate among Aboriginal and Torres Strait Islander women in Australia, and Maori and Pacific Islander women in NZ (and those who come over to Australia), it is also highly prevalent among those women who have migrated or who are refugees from resource poor countries. Part of our study is raising awareness of the impact of this disease in pregnancy.
Resources: RHDAustralia, RhEACH, Australian Guidelines ARF/RHD, our study website.
Planning for the qualitative study in Northern Territory is now powering along. Led by Dr Suzanne Belton, with investigators Professor Sue Kruske, Heather D’Antoine and Kylie Tune, we have been busy making things happen to support the study, which is exploring voices of women with RHD in pregnancy.
Message to Australian Maternity Unit Managers – survey on maternity service provision for pregnant women from refugee/immigrant backgrounds AMOSS recently sent an invitation to Australian Maternity Unit Managers on behalf of researchers from Australian Catholic University & Mater Research to complete the above survey. This is to remind you that if you have not yet completed it, there is still time to do so! We hope the results will help improve maternity care for a vulnerable group of women. Please note that by completing the survey you will be eligible to enter your details into the draw to win two gold class movie tickets. Thank you for your support! For further details contact Dr Helen Stapleton; Australian Catholic University & Mater Research t: 07 3163 6081. To access the survey please click on the link: http://www.surveygizmo.com/s3/1274378/Pregnant-women-from-refugee-immigrant-backgrounds-living-in-Australia-A-survey-of-maternity-service-provision-from-the-perspective-of-service-personnel
New database for AMOSS As some of you will know approximately 18 months ago AMOSS received an infrastructure grant from the University of NSW to redevelop the AMOSS data collection system. Improved reporting and increased number of conditions under study were putting the old infrastructure under strain and causing delays when completing surveys. The new system is using slightly different technology and different ways of capturing case data. This should improve the speed and performance of the system both for data collectors, as well as adding additional functions for use by the AMOSS office.
In practical terms it means it should make life quicker and easier for our committed volunteer data collectors and the data collected even more usable.
The new system is almost complete and it will be going live over the next month. So what does this mean for you?
• Access to the system will remain unchanged and be via the AMOSS website.
• The online forms will look and feel slightly different. We think it’s a huge improvement.
• The data required for general information and each condition will remain the same.
• You will be able to view and complete cases as before.
• Legacy cases (those from the old system) will be migrated into the new system. A closed/completed case will appear with its case ID and will show as closed. Open cases will show a link to the survey for you to click and complete. This link will be directly into the old system and you can complete the case there.
• There will be a slight delay to the start of data collection for the Massive Obstetric Haemorrhage study so that it can be implemented in the new system.
More detailed information and instructions will be provided when the new system goes live.
We want to thank you for your all your feedback, patience and support during this redevelopment. Feel free to contact the AMOSS office if you have any questions.
Chocolates and thanks... Alastair Haslam of Waikato Hospital (NZ) for responding to the AMOSS monthly emails and entering cases and Marilyn Steers of North West Private Hospital Burnie Campus (Tas) who has been terrific at responding promptly to the AMOSS monthly emails.
Spotlight on the Southern States... The Data Collectors
Simone Quinton is the bookings coordinator for Frances Perry House in Victoria and has been a data collector since 2010 Dr Stephen Raymond is a staff specialist with the Royal Hobart Hospital and the AMOSS state representative for Tasmania since 2010. Steve was also the AMOSS data collector from 2010 until the end of 2013 Dr Simon Kane is the Northern Adelaide Local Health Network (NALHN) Head of Obstetrics and is a Consultant Obstetrician & Gynaecologist at Lyell McEwin Hospital in Adelaide. Simon has been a data collectors for almost 1 year
The Hospitals
(Simone Quinton) “Frances Perry House: is a private obstetric and surgical hospital situated in Melbourne, the Hospital has 93 beds. We have 6 birthing suites, a level 2 nursery, a dedicated postnatal unit, 3 operating theatres, a day surgery unit, a urodynamics procedure room and a surgical/maternity unit. Last year there were over 3,500 babies born at Frances Perry. Perry House has the unique advantage of being co-located with the Royal Women’s Hospital. This allows us to provide our patients with the highest standard of private hospital care whilst having access to tertiary level care facilities of the Royal Women’s Hospital if required.” (Dr Steve Raymond) “The Royal Hobart Hospital: is the referral hospital for obstetrics for Tasmania, and carries out just on 2000 deliveries per year. With these rather small numbers we find we are not great contributors of cases for AMOSS. So far we have encountered but one case of vasa praevia and contributed no reports for RHD or breast cancer. On the other hand, when a case for reporting does occur, because they are rare, it does not get lost in the busy unit, but tends to present a high profile, making it hard to forget.” (Dr Simon Kane) “The Lyell McEwin Hospital: serves the northern part of the Adelaide metropolitan area, and has undergone significant expansion of provided services in recent years. Birthing numbers are now about 3500 per annum, and we are supported by a range of acute care specialties including an adult Intensive Care Unit and a Special Care Nursery. The area is one of socioeconomic disadvantage, and a significant number of pregnancies are complicated by obesity and diabetes. We also have a very diverse migrant population, with an attendant range of interesting medical co-morbidities and a wide range of expectations and challenges around birthing. We are fortunate to work with a Health Department that is supportive of a range of care models including homebirth, and to be linked to the University of Adelaide as a research and teaching hospital.”
Data Collection and AMOSS
(Simone Quinton) “Frances Perry House receives many private patients requiring specialized Obstetric care from everywhere in Victoria and sometimes interstate, we commenced participation in the AMOSS study a number of years ago and have managed to capture a broad range of obstetric conditions. We believe this work is vital to improve maternity care and decrease adverse maternal outcomes. We benefit by reflection on our practice and improving our processes that ultimately helps to provide our patients with the best possible care.” The Royal Hobart Hospital: After four years as data collector and AMOSS state representative, Staff Specialist in Obstetrics, Steve has stepped down and handed over that role to Dr. Glenn Blanchette, a fellow obstetrician. “Over those four years the task of collecting the data has become considerably easier with the introduction of ‘ObstetriXTas’, an electronic database and clinical record. AMOSS is an important project with the potential to make data available for improvement in women’s health and the Royal Hobart Hospital Queen Alexandra Maternity Unit is glad to be a part of it. (Dr Simon Kane) “I have been the AMOSS coordinator at Lyell McEwin since May 2013, and have reported eight cases in that time. The workload has been quite manageable, possibly because I missed the collection on obesity. We have had several women eligible for the AMOSS under our care. The rheumatic heart disease study is of particular interest to me as I worked in Alice Springs for many years, and am part of the AMOSS RHD in Pregnancy advisory group. Happily all women have had relatively mild disease and good obstetric outcomes. Collecting the data involves being aware of the patients, something that can be a problem in a large public hospital with limitations on continuity of care, but as a full-timer and with a variety of established in-house meetings and mechanisms in place, I usually get to hear about potential cases early on so data entry can be spread over a few months. As a clinical manager I find it very useful to review clinical data entries and processes, so I believe that involvement with the AMOSS collection has been beneficial to obstetric practice in our hospital. Clinical interactions with other disciplines have also been strengthened by better collaboration, and the whole process has encouraged us to look at other significant causes of maternal morbidity through local audits and case reviews.”
AMOSS conditions Current studies • Amniotic fluid embolism (since 2010) • Gestational breast cancer (2013 - June 14) • Rheumatic heart disease (2013-2014) • Vasa praevia (April 2013 – April 2014) • Massive obstetric haemorrhage (2014)
NewAs sommonthgrant AMOSand inwere and canew sand dshouldsystemadditi
In praquickedata cusable
The ngoing mean
• Aa
• T
• Ta
• Ya
•
ccwatc
• T
More provid
We wpatienFeel frany qu
ChocAlastarespoenteriPrivatbeen tmonth
AMO
Curr• Am• Ge• Rh• Va• Ma
Com• An
De• Ecl• Inf• Mo• Pe• Pla
database forme of you will knhs ago AMOSS refrom the Univers
SS data collectionncreased numberputting the old inausing delays whystem is using sliifferent ways of cd improve the spm both for data conal functions fo
ctical terms it meer and easier for collectors and thee.
ew system is almlive over the nexfor you?
Access to the sysand be via the AMThe online formsdifferent. We thiThe data requireand each conditioYou will be able tas before. Legacy cases (thobe migrated into closed/completecase ID and will swill show a link toand complete. Ththe old system ancase there. There has been adata collection foHaemorrhage stuimplemented in t
detailed informaded when the new
ant to thank you nce and support dree to contact thuestions.
colates and tair Haslam of Wanding to the AMOing cases and Mate Hospital Burniterrific at responhly emails.
OSS conditions
ent studies mniotic fluid embestational breast ceumatic heart disa praevia (April
eceived an infrastsity of NSW to ren system. Improvr of conditions unnfrastructure unden completing suightly different tecapturing case daeed and perform
collectors, as wellor use by the AMO
eans it should maour committed v
e data collected e
most complete anxt month. So wha
stem will remain MOSS website. s will look and feenk it’s a huge impd for general infoon will remain thto view and comp
ose from the old the new system.d case will appea
show as closed. Oo the survey for yhis link will be dirnd you can comp
a slight delay to tor the Massive Obudy so that it canthe new system.
ation and instructw system goes liv
for your all yourduring this redeve AMOSS office if
thanks... ikato Hospital (NOSS monthly emaarilyn Steers of Noe Campus (Tas) wding promptly to
s
olism (since 2010cancer (2013 - Jusease (2013-20142013 – April 201
haemorrhage (20
s ry embolism (cea
mission MI > 50) ectomy
ly 18 tructure develop the ed reporting
nder study der strain urveys. The echnology ata. This
mance of the l as adding OSS office.
ake life volunteer even more
d it will be at does this
unchanged
el slightly provement. ormation he same. plete cases
system) will . A ar with its Open cases you to click rectly into plete the
he start of bstetric be
tions will be ve.
r feedback, velopment. f you have
NZ) for ails and orth West who has o the AMOSS
0) ne 14) 4) 4) 14)
ased 31
SpotlighThe Data Coll
Simone Quintodata collector sDr Stephen Rayrepresentative until the end oDr Simon Kaneis a Consultantbeen a data co
The Hospitals
(Simone QuintMelbourne, thepostnatal unit, surgical/materHouse has the allows us to proaccess to tertia(Dr Steve RaymTasmania, andfind we are notcontributed no does occur, bechigh profile, ma(Dr Simon Kanemetropolitan aBirthing numbecare specialtiesof socioeconomobesity and diaof interesting mbirthing. We arcare models incteaching hospit
Data Collectio
(Simone QuintObstetric care fparticipation inrange of obstetdecrease adverprocesses that The Royal HobStaff Specialist Blanchette, a febecome considclinical record. improvement inis glad to be a p(Dr Simon Kanereported eight missed the collcare. The rheumfor many yearshave had relatiaware of the paon continuity omechanisms inspread over a fand processes,obstetric practstrengthened bsignificant caus
ht on the lectors
on is the bookingsince 2010 ymond is a staff for Tasmania sif 2013
e is the Northernt Obstetrician & ollectors for almo
s
ton) “Frances Pee Hospital has 93 3 operating the
rnity unit. Last yeunique advantaovide our patien
ary level care facmond) “The Royd carries out just t great contribut reports for RHDcause they are raking it hard to fe) “The Lyell Mc
area, and has uners are now abos including an ad
mic disadvantageabetes. We also medical co-morbre fortunate to wcluding homebirtal.”
on and AMOSS
ton) “Frances Pefrom everywher
n the AMOSS stutric conditions. Wrse maternal outultimately helps
bart Hospital: Aftin Obstetrics, St
ellow obstetriciaderably easier wi
AMOSS is an imn women’s healpart of it. e) “I have been cases in that ti
lection on obesimatic heart dises, and am part oively mild diseasatients, somethi
of care, but as a n place, I usuallyfew months. As a, so I believe thtice in our hospby better collaboses of maternal
Southern
gs coordinator f
f specialist with nce 2010. Steve
n Adelaide LocalGynaecologist aost 1 year
erry House: is a p3 beds. We have
eatres, a day surear there were oge of being co-lo
nts with the highcilities of the Roy
yal Hobart Hospion 2000 deliver
tors of cases for D or breast canceare, it does not gforget.” cEwin Hospital:dergone significut 3500 per anndult Intensive Cae, and a significahave a very dive
bidities and a widwork with a Hearth, and to be lin
S
erry House receire in Victoria andudy a number of We believe this wtcomes. We bens to provide our ter four years asteve has steppean. “Over thoseith the introduct
mportant projectth and the Roya
the AMOSS coorime. The workloity. We have hadease study is of pof the AMOSS RHse and good obsing that can be afull-timer and w
y get to hear aba clinical managat involvement pital. Clinical inoration, and themorbidity throu
n States..
or Frances Perry
the Royal Hobare was also the AM
Health Networkat Lyell McEwin H
private obstetrice 6 birthing suitegery unit, a urod
over 3,500 babieocated with the
hest standard of yal Women’s Hoital: is the referrries per year. Wi
AMOSS. So far er. On the otherget lost in the bu
serves the northcant expansion onum, and we areare Unit and a Spant number of perse migrant popde range of expelth Department
nked to the Unive
ves many privatd sometimes inteyears ago and h
work is vital to imefit by reflectionpatients with th
s data collector ad down and hanfour years the t
tion of ‘ObstetriXt with the potentl Hobart Hospita
rdinator at Lyellad has been qud several wome
particular interesHD in Pregnancystetric outcomesa problem in a lawith a variety ofbout potential cger I find it very u
with the AMOSnteractions withe whole process ugh local audits a
..
y House in Victo
rt Hospital and tMOSS data colle
k (NALHN) HeadHospital in Adel
c and surgical hoes, a level 2 nursdynamics procedes born at France
Royal Women’sf private hospitaospital if requiredral hospital for o
With these rather we have encoun
r hand, when a cusy unit, but ten
hern part of the of provided servie supported by apecial Care Nurs
pregnancies are pulation, with anectations and chthat is supporti
versity of Adelaid
te patients requierstate, we comhave managed tmprove maternin on our practicehe best possible and AMOSS stat
nded over that rtask of collectingXTas’, an electrotial to make datal Queen Alexan
l McEwin since Muite manageableen eligible for thst to me as I wo
y advisory groups. Collecting the arge public hospf established in-hcases early on souseful to reviewSS collection hah other disciplinhas encouragedand case review
oria and has bee
the AMOSS stateector from 2010
d of Obstetrics aaide. Simon has
ospital situated sery, a dedicateddure room and aes Perry. Perry s Hospital. This l care whilst havd.”
obstetrics for small numbers
ntered but case for reportinnds to present a
Adelaide ices in recent yea
a range of acute sery. The area is complicated by n attendant ranghallenges aroundve of a range of
de as a research
iring specialized mmenced to capture a broaity care and e and improvingcare.” te representativole to Dr. Glenng the data has onic database anta available for ndra Maternity U
May 2013, and he, possibly becauhe AMOSS under
rked in Alice Sprp. Happily all wo
data involves bpital with limitathouse meetings o data entry ca
w clinical data ens been beneficianes have also bd us to look at o
ws.”
n a
e
nd
in d a
ving
we
ng
ars.
one
ge d f
and
ad
g our
e,
nd
Unit
have use I r our rings men
being tions and n be tries al to been other
NewAs sommonthgrant AMOSand inwere and canew sand dshouldsystemadditi
In praquickedata cusable
The ngoing mean
• Aa
• T
• Ta
• Ya
•
ccwatc
• T
More provid
We wpatienFeel frany qu
ChocAlastarespoenteriPrivatbeen tmonth
AMO
Curr• Am• Ge• Rh• Va• Ma
Com• An
De• Ecl• Inf• Mo• Pe• Pla
database forme of you will knhs ago AMOSS refrom the Univers
SS data collectionncreased numberputting the old inausing delays whystem is using sliifferent ways of cd improve the spm both for data conal functions fo
ctical terms it meer and easier for collectors and thee.
ew system is almlive over the nexfor you?
Access to the sysand be via the AMThe online formsdifferent. We thiThe data requireand each conditioYou will be able tas before. Legacy cases (thobe migrated into closed/completecase ID and will swill show a link toand complete. Ththe old system ancase there. There has been adata collection foHaemorrhage stuimplemented in t
detailed informaded when the new
ant to thank you nce and support dree to contact thuestions.
colates and tair Haslam of Wanding to the AMOing cases and Mate Hospital Burniterrific at responhly emails.
OSS conditions
ent studies mniotic fluid embestational breast ceumatic heart disa praevia (April
eceived an infrastsity of NSW to ren system. Improvr of conditions unnfrastructure unden completing suightly different tecapturing case daeed and perform
collectors, as wellor use by the AMO
eans it should maour committed v
e data collected e
most complete anxt month. So wha
stem will remain MOSS website. s will look and feenk it’s a huge impd for general infoon will remain thto view and comp
ose from the old the new system.d case will appea
show as closed. Oo the survey for yhis link will be dirnd you can comp
a slight delay to tor the Massive Obudy so that it canthe new system.
ation and instructw system goes liv
for your all yourduring this redeve AMOSS office if
thanks... ikato Hospital (NOSS monthly emaarilyn Steers of Noe Campus (Tas) wding promptly to
s
olism (since 2010cancer (2013 - Jusease (2013-20142013 – April 201
haemorrhage (20
s ry embolism (cea
mission MI > 50) ectomy
ly 18 tructure develop the ed reporting
nder study der strain urveys. The echnology ata. This
mance of the l as adding OSS office.
ake life volunteer even more
d it will be at does this
unchanged
el slightly provement. ormation he same. plete cases
system) will . A ar with its Open cases you to click rectly into plete the
he start of bstetric be
tions will be ve.
r feedback, velopment. f you have
NZ) for ails and orth West who has o the AMOSS
0) ne 14) 4) 4) 14)
ased 31
SpotlighThe Data Coll
Simone Quintodata collector sDr Stephen Rayrepresentative until the end oDr Simon Kaneis a Consultantbeen a data co
The Hospitals
(Simone QuintMelbourne, thepostnatal unit, surgical/materHouse has the allows us to proaccess to tertia(Dr Steve RaymTasmania, andfind we are notcontributed no does occur, bechigh profile, ma(Dr Simon Kanemetropolitan aBirthing numbecare specialtiesof socioeconomobesity and diaof interesting mbirthing. We arcare models incteaching hospit
Data Collectio
(Simone QuintObstetric care fparticipation inrange of obstetdecrease adverprocesses that The Royal HobStaff Specialist Blanchette, a febecome considclinical record. improvement inis glad to be a p(Dr Simon Kanereported eight missed the collcare. The rheumfor many yearshave had relatiaware of the paon continuity omechanisms inspread over a fand processes,obstetric practstrengthened bsignificant caus
ht on the lectors
on is the bookingsince 2010 ymond is a staff for Tasmania sif 2013
e is the Northernt Obstetrician & ollectors for almo
s
ton) “Frances Pee Hospital has 93 3 operating the
rnity unit. Last yeunique advantaovide our patien
ary level care facmond) “The Royd carries out just t great contribut reports for RHDcause they are raking it hard to fe) “The Lyell Mc
area, and has uners are now abos including an ad
mic disadvantageabetes. We also medical co-morbre fortunate to wcluding homebirtal.”
on and AMOSS
ton) “Frances Pefrom everywher
n the AMOSS stutric conditions. Wrse maternal outultimately helps
bart Hospital: Aftin Obstetrics, St
ellow obstetriciaderably easier wi
AMOSS is an imn women’s healpart of it. e) “I have been cases in that ti
lection on obesimatic heart dises, and am part oively mild diseasatients, somethi
of care, but as a n place, I usuallyfew months. As a, so I believe thtice in our hospby better collaboses of maternal
Southern
gs coordinator f
f specialist with nce 2010. Steve
n Adelaide LocalGynaecologist aost 1 year
erry House: is a p3 beds. We have
eatres, a day surear there were oge of being co-lo
nts with the highcilities of the Roy
yal Hobart Hospion 2000 deliver
tors of cases for D or breast canceare, it does not gforget.” cEwin Hospital:dergone significut 3500 per anndult Intensive Cae, and a significahave a very dive
bidities and a widwork with a Hearth, and to be lin
S
erry House receire in Victoria andudy a number of We believe this wtcomes. We bens to provide our ter four years asteve has steppean. “Over thoseith the introduct
mportant projectth and the Roya
the AMOSS coorime. The workloity. We have hadease study is of pof the AMOSS RHse and good obsing that can be afull-timer and w
y get to hear aba clinical managat involvement pital. Clinical inoration, and themorbidity throu
n States..
or Frances Perry
the Royal Hobare was also the AM
Health Networkat Lyell McEwin H
private obstetrice 6 birthing suitegery unit, a urod
over 3,500 babieocated with the
hest standard of yal Women’s Hoital: is the referrries per year. Wi
AMOSS. So far er. On the otherget lost in the bu
serves the northcant expansion onum, and we areare Unit and a Spant number of perse migrant popde range of expelth Department
nked to the Unive
ves many privatd sometimes inteyears ago and h
work is vital to imefit by reflectionpatients with th
s data collector ad down and hanfour years the t
tion of ‘ObstetriXt with the potentl Hobart Hospita
rdinator at Lyellad has been qud several wome
particular interesHD in Pregnancystetric outcomesa problem in a lawith a variety ofbout potential cger I find it very u
with the AMOSnteractions withe whole process ugh local audits a
..
y House in Victo
rt Hospital and tMOSS data colle
k (NALHN) HeadHospital in Adel
c and surgical hoes, a level 2 nursdynamics procedes born at France
Royal Women’sf private hospitaospital if requiredral hospital for o
With these rather we have encoun
r hand, when a cusy unit, but ten
hern part of the of provided servie supported by apecial Care Nurs
pregnancies are pulation, with anectations and chthat is supporti
versity of Adelaid
te patients requierstate, we comhave managed tmprove maternin on our practicehe best possible and AMOSS stat
nded over that rtask of collectingXTas’, an electrotial to make datal Queen Alexan
l McEwin since Muite manageableen eligible for thst to me as I wo
y advisory groups. Collecting the arge public hospf established in-hcases early on souseful to reviewSS collection hah other disciplinhas encouragedand case review
oria and has bee
the AMOSS stateector from 2010
d of Obstetrics aaide. Simon has
ospital situated sery, a dedicateddure room and aes Perry. Perry s Hospital. This l care whilst havd.”
obstetrics for small numbers
ntered but case for reportinnds to present a
Adelaide ices in recent yea
a range of acute sery. The area is complicated by n attendant ranghallenges aroundve of a range of
de as a research
iring specialized mmenced to capture a broaity care and e and improvingcare.” te representativole to Dr. Glenng the data has onic database anta available for ndra Maternity U
May 2013, and he, possibly becauhe AMOSS under
rked in Alice Sprp. Happily all wo
data involves bpital with limitathouse meetings o data entry ca
w clinical data ens been beneficianes have also bd us to look at o
NewAs sommonthgrant AMOSand inwere and canew sand dshouldsystemadditi
In praquickedata cusable
The ngoing mean
• Aa
• T
• Ta
• Ya
•
ccwatc
• T
More provid
We wpatienFeel frany qu
ChocAlastarespoenteriPrivatbeen tmonth
AMO
Curr• Am• Ge• Rh• Va• Ma
Com• An
De• Ecl• Inf• Mo• Pe• Pla
database forme of you will knhs ago AMOSS refrom the Univers
SS data collectionncreased numberputting the old inausing delays whystem is using sliifferent ways of cd improve the spm both for data conal functions fo
ctical terms it meer and easier for collectors and thee.
ew system is almlive over the nexfor you?
Access to the sysand be via the AMThe online formsdifferent. We thiThe data requireand each conditioYou will be able tas before. Legacy cases (thobe migrated into closed/completecase ID and will swill show a link toand complete. Ththe old system ancase there. There has been adata collection foHaemorrhage stuimplemented in t
detailed informaded when the new
ant to thank you nce and support dree to contact thuestions.
colates and tair Haslam of Wanding to the AMOing cases and Mate Hospital Burniterrific at responhly emails.
OSS conditions
ent studies mniotic fluid embestational breast ceumatic heart disa praevia (April
eceived an infrastsity of NSW to ren system. Improvr of conditions unnfrastructure unden completing suightly different tecapturing case daeed and perform
collectors, as wellor use by the AMO
eans it should maour committed v
e data collected e
most complete anxt month. So wha
stem will remain MOSS website. s will look and feenk it’s a huge impd for general infoon will remain thto view and comp
ose from the old the new system.d case will appea
show as closed. Oo the survey for yhis link will be dirnd you can comp
a slight delay to tor the Massive Obudy so that it canthe new system.
ation and instructw system goes liv
for your all yourduring this redeve AMOSS office if
thanks... ikato Hospital (NOSS monthly emaarilyn Steers of Noe Campus (Tas) wding promptly to
s
olism (since 2010cancer (2013 - Jusease (2013-20142013 – April 201
haemorrhage (20
s ry embolism (cea
mission MI > 50) ectomy
ly 18 tructure develop the ed reporting
nder study der strain urveys. The echnology ata. This
mance of the l as adding OSS office.
ake life volunteer even more
d it will be at does this
unchanged
el slightly provement. ormation he same. plete cases
system) will . A ar with its Open cases you to click rectly into plete the
he start of bstetric be
tions will be ve.
r feedback, velopment. f you have
NZ) for ails and orth West who has o the AMOSS
0) ne 14) 4) 4) 14)
ased 31
SpotlighThe Data Coll
Simone Quintodata collector sDr Stephen Rayrepresentative until the end oDr Simon Kaneis a Consultantbeen a data co
The Hospitals
(Simone QuintMelbourne, thepostnatal unit, surgical/materHouse has the allows us to proaccess to tertia(Dr Steve RaymTasmania, andfind we are notcontributed no does occur, bechigh profile, ma(Dr Simon Kanemetropolitan aBirthing numbecare specialtiesof socioeconomobesity and diaof interesting mbirthing. We arcare models incteaching hospit
Data Collectio
(Simone QuintObstetric care fparticipation inrange of obstetdecrease adverprocesses that The Royal HobStaff Specialist Blanchette, a febecome considclinical record. improvement inis glad to be a p(Dr Simon Kanereported eight missed the collcare. The rheumfor many yearshave had relatiaware of the paon continuity omechanisms inspread over a fand processes,obstetric practstrengthened bsignificant caus
ht on the lectors
on is the bookingsince 2010 ymond is a staff for Tasmania sif 2013
e is the Northernt Obstetrician & ollectors for almo
s
ton) “Frances Pee Hospital has 93 3 operating the
rnity unit. Last yeunique advantaovide our patien
ary level care facmond) “The Royd carries out just t great contribut reports for RHDcause they are raking it hard to fe) “The Lyell Mc
area, and has uners are now abos including an ad
mic disadvantageabetes. We also medical co-morbre fortunate to wcluding homebirtal.”
on and AMOSS
ton) “Frances Pefrom everywher
n the AMOSS stutric conditions. Wrse maternal outultimately helps
bart Hospital: Aftin Obstetrics, St
ellow obstetriciaderably easier wi
AMOSS is an imn women’s healpart of it. e) “I have been cases in that ti
lection on obesimatic heart dises, and am part oively mild diseasatients, somethi
of care, but as a n place, I usuallyfew months. As a, so I believe thtice in our hospby better collaboses of maternal
Southern
gs coordinator f
f specialist with nce 2010. Steve
n Adelaide LocalGynaecologist aost 1 year
erry House: is a p3 beds. We have
eatres, a day surear there were oge of being co-lo
nts with the highcilities of the Roy
yal Hobart Hospion 2000 deliver
tors of cases for D or breast canceare, it does not gforget.” cEwin Hospital:dergone significut 3500 per anndult Intensive Cae, and a significahave a very dive
bidities and a widwork with a Hearth, and to be lin
S
erry House receire in Victoria andudy a number of We believe this wtcomes. We bens to provide our ter four years asteve has steppean. “Over thoseith the introduct
mportant projectth and the Roya
the AMOSS coorime. The workloity. We have hadease study is of pof the AMOSS RHse and good obsing that can be afull-timer and w
y get to hear aba clinical managat involvement pital. Clinical inoration, and themorbidity throu
n States..
or Frances Perry
the Royal Hobare was also the AM
Health Networkat Lyell McEwin H
private obstetrice 6 birthing suitegery unit, a urod
over 3,500 babieocated with the
hest standard of yal Women’s Hoital: is the referrries per year. Wi
AMOSS. So far er. On the otherget lost in the bu
serves the northcant expansion onum, and we areare Unit and a Spant number of perse migrant popde range of expelth Department
nked to the Unive
ves many privatd sometimes inteyears ago and h
work is vital to imefit by reflectionpatients with th
s data collector ad down and hanfour years the t
tion of ‘ObstetriXt with the potentl Hobart Hospita
rdinator at Lyellad has been qud several wome
particular interesHD in Pregnancystetric outcomesa problem in a lawith a variety ofbout potential cger I find it very u
with the AMOSnteractions withe whole process ugh local audits a
..
y House in Victo
rt Hospital and tMOSS data colle
k (NALHN) HeadHospital in Adel
c and surgical hoes, a level 2 nursdynamics procedes born at France
Royal Women’sf private hospitaospital if requiredral hospital for o
With these rather we have encoun
r hand, when a cusy unit, but ten
hern part of the of provided servie supported by apecial Care Nurs
pregnancies are pulation, with anectations and chthat is supporti
versity of Adelaid
te patients requierstate, we comhave managed tmprove maternin on our practicehe best possible and AMOSS stat
nded over that rtask of collectingXTas’, an electrotial to make datal Queen Alexan
l McEwin since Muite manageableen eligible for thst to me as I wo
y advisory groups. Collecting the arge public hospf established in-hcases early on souseful to reviewSS collection hah other disciplinhas encouragedand case review
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AMOSS Team Nasrin Javid, AMOSS Project Coordinator, UNSW Medicine Michele Partridge, UNSW Medicine Tel 02 9382 1068 E [email protected] URL: www.amoss.com.au
NZ Coordinator Vicki Masson Tel 09 923 4440 E [email protected] RHD Coordinators Geraldine Vaughan, UNSW Medicine Tel 02 9382 1564 E [email protected] Kylie Tune, Menzies School of Health Research Tel 0448 777780 E [email protected] Faith Mahony, Auckland City Hospital NZ Tel 09 3074949 Ex25342 E [email protected]
AMOSS Investigators Chief: Professor Elizabeth Sullivan, UNSW Medicine; Professor Michael Peek, University of Sydney; Professor Marian Knight, University of Oxford; Professor David Ellwood, Griffith University; Professor Lisa Jackson Pulver, UNSW Medicine; Professor Caroline Homer, University of Technology Sydney; Dr Claire McLintock, Auckland City Hospital, NZ; Associate: Prof Elizabeth Elliott, APSU: The Children’s Hospital Westmead; Dr Tessa Ho, Mary Aikenhead Ministries; A/Prof Nolan McDonnell, King Edward Memorial Hospital for Women, WA; Dr Wendy Pollock, La Trobe University/Mercy Hospital for Women, Victoria; A/Prof Yvonne Zurynski, APSU, The Children’s Hospital Westmead, Sydney
Gestational Breast Cancer Investigators Professor Elizabeth Sullivan, UNSW Medicine Winthrop Professor Christobel Saunders, University of Western Australia; Professor Jan Dickinson, University of Western Australia; Dr Angela Ives, University of Western Australia; Professor Jane Fisher, Monash University; Dr Greg Duncombe, Royal Brisbane Women’s Hospital; Dr Karin Hammarberg, Monash University
Massive Obstetric Haemorrhage Professor Elizabeth Sullivan, UNSW Medicine; Dr Claire McLintock, Auckland City Hospital; Dr Erica Wood, Australian Red Cross Blood Service; Dr Zoe McQuilten, Monash University; Professor David Ellwood, Griffith University; Dr Wendy Pollock, La Trobe University; A/Prof Andrew Bisits, Royal Hospital for Women; Dr Amanda Henry, UNSW Medicine
RHD Investigators Chief: Professor Elizabeth Sullivan, UNSW Medicine; Professor Lisa Jackson Pulver, UNSW Medicine; Professor Jonathan Carapetis, Telethon Institute for Child Health Research; Dr Warren Walsh, UNSW Medicine; Professor Michael Peek, University of Sydney; Dr Claire McLintock Auckland City Hospital Associate: Dr Suzanne Belton, University of Sydney; Professor Alex Brown, Baker IDI NT; A/ Professor Elizabeth Comino, UNSW Medicine; Ms Heather D’Antoine, University of Sydney; Dr Simon Kane, Lyell McEwin Hospital, Adelaide; Professor Juanita Sherwood, University of Technology Sydney; Dr Sujatha Thomas, Royal Darwin Hospital, Darwin; Dr Bo Remenyi, Menzies NT; Ms Geri Vaughan, UNSW Medicine
Vasa Praevia Investigators Professor Elizabeth Sullivan, UNSW Medicine; A/Prof Yinka Oyelese Jersey Shore University Medical Centre; A/Prof Robert Cincotta, Mater Mothers Hospital; Dr Greg Duncombe, Royal Brisbane Women’s Hospital; Professor Caroline Homer, University of Technology Sydney
Funding We gratefully acknowledge the following funding: NHMRC; [AMOSS #510298; Rheumatic heart disease (RHD) # 1024206]; National Breast Cancer Foundation [Novel Concept Award]; International Vasa Previa Foundation: [Vasa previa study]; UNSW Major Research Equipment and Infrastructure Initiative (MREII); Australian Red Cross Blood Service and Royal Hospital for Women Foundation Board: (Massive obstetric haemorrhage study)
Gestational Breast Cancer (GBC) Update The AMOSS gestational breast cancer (GBC) study has been extended until June 30th 2014, as data collection for this study has resulted in only a small number of cases reported to date. AMOSS has been working with the Breast Cancer Network Australia (BCNA) to enhance data collection and capture women who have been diagnosed with breast cancer whilst pregnant. In the latest edition of the Beacon magazine there is a half page article on the AMOSS study The BEACON magazine Issue 66
Vasa Praevia (VP) The vasa praevia (VP) study will cease data collection on April 30 2014. This worthwhile study has been the first international prospective population based study on this rare but potentially fatal condition Please continue to notify the AMOSS office if you have had a vasa praevia case occur at your hospital from April 2013 until the end of April 2014. For more information on vasa praevia: The Royal Australian and New Zealand College of Obstetricians & Gynaecologists – College Statements 2012
Rebarber, A., Dolin, C., Fox, NS., Klauser, CK., Saltzman, DH., Roman, AS. (2014). Natural history of vasa previa across gestation using a screening protocol. Journal of ultrasound in medicine, 33(1): 141-147.
New AMOSS Study for 2014 Massive Obstetric Haemorrhage (MOH) Data collection for the study of MOH will be commencing shortly. Inclusion criteria: All women who experience an obstetric haemorrhage at ≥ 20 weeks gestation, or within 24 hours postpartum and 1. Receive 5 or more units of red blood cells within 4 hours, and 2. Bleeding originates from the genital tract or uterus
Rheumatic heart disease in pregnancy We’re in our second year of data collection for the quantitative study of this condition. Thanks so much for your input! While RHD is very disproportionate among Aboriginal and Torres Strait Islander women in Australia, and Maori and Pacific Islander women in NZ (and those who come over to Australia), it is also highly prevalent among those women who have migrated or who are refugees from resource poor countries. Part of our study is raising awareness of the impact of this disease in pregnancy.
Resources: RHDAustralia, RhEACH, Australian Guidelines ARF/RHD, our study website.
Planning for the qualitative study in Northern Territory is now powering along. Led by Dr Suzanne Belton, with investigators Professor Sue Kruske, Heather D’Antoine and Kylie Tune, we have been busy making things happen to support the study, which is exploring voices of women with RHD in pregnancy.
Message to Australian Maternity Unit Managers – survey on maternity service provision for pregnant women from refugee/immigrant backgrounds AMOSS recently sent an invitation to Australian Maternity Unit Managers on behalf of researchers from Australian Catholic University & Mater Research to complete the above survey. This is to remind you that if you have not yet completed it, there is still time to do so! We hope the results will help improve maternity care for a vulnerable group of women. Please note that by completing the survey you will be eligible to enter your details into the draw to win two gold class movie tickets. Thank you for your support! For further details contact Dr Helen Stapleton; Australian Catholic University & Mater Research t: 07 3163 6081. To access the survey please click on the link: http://www.surveygizmo.com/s3/1274378/Pregnant-women-from-refugee-immigrant-backgrounds-living-in-Australia-A-survey-of-maternity-service-provision-from-the-perspective-of-service-personnel
New database for AMOSS As some of you will know approximately 18 months ago AMOSS received an infrastructure grant from the University of NSW to redevelop the AMOSS data collection system. Improved reporting and increased number of conditions under study were putting the old infrastructure under strain and causing delays when completing surveys. The new system is using slightly different technology and different ways of capturing case data. This should improve the speed and performance of the system both for data collectors, as well as adding additional functions for use by the AMOSS office.
In practical terms it means it should make life quicker and easier for our committed volunteer data collectors and the data collected even more usable.
The new system is almost complete and it will be going live over the next month. So what does this mean for you?
• Access to the system will remain unchanged and be via the AMOSS website.
• The online forms will look and feel slightly different. We think it’s a huge improvement.
• The data required for general information and each condition will remain the same.
• You will be able to view and complete cases as before.
• Legacy cases (those from the old system) will be migrated into the new system. A closed/completed case will appear with its case ID and will show as closed. Open cases will show a link to the survey for you to click and complete. This link will be directly into the old system and you can complete the case there.
• There will be a slight delay to the start of data collection for the Massive Obstetric Haemorrhage study so that it can be implemented in the new system.
More detailed information and instructions will be provided when the new system goes live.
We want to thank you for your all your feedback, patience and support during this redevelopment. Feel free to contact the AMOSS office if you have any questions.
Chocolates and thanks... Alastair Haslam of Waikato Hospital (NZ) for responding to the AMOSS monthly emails and entering cases and Marilyn Steers of North West Private Hospital Burnie Campus (Tas) who has been terrific at responding promptly to the AMOSS monthly emails.
Spotlight on the Southern States... The Data Collectors
Simone Quinton is the bookings coordinator for Frances Perry House in Victoria and has been a data collector since 2010 Dr Stephen Raymond is a staff specialist with the Royal Hobart Hospital and the AMOSS state representative for Tasmania since 2010. Steve was also the AMOSS data collector from 2010 until the end of 2013 Dr Simon Kane is the Northern Adelaide Local Health Network (NALHN) Head of Obstetrics and is a Consultant Obstetrician & Gynaecologist at Lyell McEwin Hospital in Adelaide. Simon has been a data collectors for almost 1 year
The Hospitals
(Simone Quinton) “Frances Perry House: is a private obstetric and surgical hospital situated in Melbourne, the Hospital has 93 beds. We have 6 birthing suites, a level 2 nursery, a dedicated postnatal unit, 3 operating theatres, a day surgery unit, a urodynamics procedure room and a surgical/maternity unit. Last year there were over 3,500 babies born at Frances Perry. Perry House has the unique advantage of being co-located with the Royal Women’s Hospital. This allows us to provide our patients with the highest standard of private hospital care whilst having access to tertiary level care facilities of the Royal Women’s Hospital if required.” (Dr Steve Raymond) “The Royal Hobart Hospital: is the referral hospital for obstetrics for Tasmania, and carries out just on 2000 deliveries per year. With these rather small numbers we find we are not great contributors of cases for AMOSS. So far we have encountered but one case of vasa praevia and contributed no reports for RHD or breast cancer. On the other hand, when a case for reporting does occur, because they are rare, it does not get lost in the busy unit, but tends to present a high profile, making it hard to forget.” (Dr Simon Kane) “The Lyell McEwin Hospital: serves the northern part of the Adelaide metropolitan area, and has undergone significant expansion of provided services in recent years. Birthing numbers are now about 3500 per annum, and we are supported by a range of acute care specialties including an adult Intensive Care Unit and a Special Care Nursery. The area is one of socioeconomic disadvantage, and a significant number of pregnancies are complicated by obesity and diabetes. We also have a very diverse migrant population, with an attendant range of interesting medical co-morbidities and a wide range of expectations and challenges around birthing. We are fortunate to work with a Health Department that is supportive of a range of care models including homebirth, and to be linked to the University of Adelaide as a research and teaching hospital.”
Data Collection and AMOSS
(Simone Quinton) “Frances Perry House receives many private patients requiring specialized Obstetric care from everywhere in Victoria and sometimes interstate, we commenced participation in the AMOSS study a number of years ago and have managed to capture a broad range of obstetric conditions. We believe this work is vital to improve maternity care and decrease adverse maternal outcomes. We benefit by reflection on our practice and improving our processes that ultimately helps to provide our patients with the best possible care.” The Royal Hobart Hospital: After four years as data collector and AMOSS state representative, Staff Specialist in Obstetrics, Steve has stepped down and handed over that role to Dr. Glenn Blanchette, a fellow obstetrician. “Over those four years the task of collecting the data has become considerably easier with the introduction of ‘ObstetriXTas’, an electronic database and clinical record. AMOSS is an important project with the potential to make data available for improvement in women’s health and the Royal Hobart Hospital Queen Alexandra Maternity Unit is glad to be a part of it. (Dr Simon Kane) “I have been the AMOSS coordinator at Lyell McEwin since May 2013, and have reported eight cases in that time. The workload has been quite manageable, possibly because I missed the collection on obesity. We have had several women eligible for the AMOSS under our care. The rheumatic heart disease study is of particular interest to me as I worked in Alice Springs for many years, and am part of the AMOSS RHD in Pregnancy advisory group. Happily all women have had relatively mild disease and good obstetric outcomes. Collecting the data involves being aware of the patients, something that can be a problem in a large public hospital with limitations on continuity of care, but as a full-timer and with a variety of established in-house meetings and mechanisms in place, I usually get to hear about potential cases early on so data entry can be spread over a few months. As a clinical manager I find it very useful to review clinical data entries and processes, so I believe that involvement with the AMOSS collection has been beneficial to obstetric practice in our hospital. Clinical interactions with other disciplines have also been strengthened by better collaboration, and the whole process has encouraged us to look at other significant causes of maternal morbidity through local audits and case reviews.”
AMOSS conditions Current studies • Amniotic fluid embolism (since 2010) • Gestational breast cancer (2013 - June 14) • Rheumatic heart disease (2013-2014) • Vasa praevia (April 2013 – April 2014) • Massive obstetric haemorrhage (2014)
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bart Hospital: Aftin Obstetrics, St
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lection on obesimatic heart dises, and am part oively mild diseasatients, somethi
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gs coordinator f
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n Adelaide LocalGynaecologist aost 1 year
erry House: is a p3 beds. We have
eatres, a day surear there were oge of being co-lo
nts with the highcilities of the Roy
yal Hobart Hospion 2000 deliver
tors of cases for D or breast canceare, it does not gforget.” cEwin Hospital:dergone significut 3500 per anndult Intensive Cae, and a significahave a very dive
bidities and a widwork with a Hearth, and to be lin
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erry House receire in Victoria andudy a number of We believe this wtcomes. We bens to provide our ter four years asteve has steppean. “Over thoseith the introduct
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y get to hear aba clinical managat involvement pital. Clinical inoration, and themorbidity throu
n States..
or Frances Perry
the Royal Hobare was also the AM
Health Networkat Lyell McEwin H
private obstetrice 6 birthing suitegery unit, a urod
over 3,500 babieocated with the
hest standard of yal Women’s Hoital: is the referrries per year. Wi
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rdinator at Lyellad has been qud several wome
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rt Hospital and tMOSS data colle
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c and surgical hoes, a level 2 nursdynamics procedes born at France
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r hand, when a cusy unit, but ten
hern part of the of provided servie supported by apecial Care Nurs
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l McEwin since Muite manageableen eligible for thst to me as I wo
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d of Obstetrics aaide. Simon has
ospital situated sery, a dedicateddure room and aes Perry. Perry s Hospital. This l care whilst havd.”
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ntered but case for reportinnds to present a
Adelaide ices in recent yea
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de as a research
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detailed informaded when the new
ant to thank you nce and support dree to contact thuestions.
colates and tair Haslam of Wanding to the AMOing cases and Mate Hospital Burniterrific at responhly emails.
OSS conditions
ent studies mniotic fluid embestational breast ceumatic heart disa praevia (April
eceived an infrastsity of NSW to ren system. Improvr of conditions unnfrastructure unden completing suightly different tecapturing case daeed and perform
collectors, as wellor use by the AMO
eans it should maour committed v
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most complete anxt month. So wha
stem will remain MOSS website. s will look and feenk it’s a huge impd for general infoon will remain thto view and comp
ose from the old the new system.d case will appea
show as closed. Oo the survey for yhis link will be dirnd you can comp
a slight delay to tor the Massive Obudy so that it canthe new system.
ation and instructw system goes liv
for your all yourduring this redeve AMOSS office if
thanks... ikato Hospital (NOSS monthly emaarilyn Steers of Noe Campus (Tas) wding promptly to
s
olism (since 2010cancer (2013 - Jusease (2013-20142013 – April 201
haemorrhage (20
s ry embolism (cea
mission MI > 50) ectomy
ly 18 tructure develop the ed reporting
nder study der strain urveys. The echnology ata. This
mance of the l as adding OSS office.
ake life volunteer even more
d it will be at does this
unchanged
el slightly provement. ormation he same. plete cases
system) will . A ar with its Open cases you to click rectly into plete the
he start of bstetric be
tions will be ve.
r feedback, velopment. f you have
NZ) for ails and orth West who has o the AMOSS
0) ne 14) 4) 4) 14)
ased 31
SpotlighThe Data Coll
Simone Quintodata collector sDr Stephen Rayrepresentative until the end oDr Simon Kaneis a Consultantbeen a data co
The Hospitals
(Simone QuintMelbourne, thepostnatal unit, surgical/materHouse has the allows us to proaccess to tertia(Dr Steve RaymTasmania, andfind we are notcontributed no does occur, bechigh profile, ma(Dr Simon Kanemetropolitan aBirthing numbecare specialtiesof socioeconomobesity and diaof interesting mbirthing. We arcare models incteaching hospit
Data Collectio
(Simone QuintObstetric care fparticipation inrange of obstetdecrease adverprocesses that The Royal HobStaff Specialist Blanchette, a febecome considclinical record. improvement inis glad to be a p(Dr Simon Kanereported eight missed the collcare. The rheumfor many yearshave had relatiaware of the paon continuity omechanisms inspread over a fand processes,obstetric practstrengthened bsignificant caus
ht on the lectors
on is the bookingsince 2010 ymond is a staff for Tasmania sif 2013
e is the Northernt Obstetrician & ollectors for almo
s
ton) “Frances Pee Hospital has 93 3 operating the
rnity unit. Last yeunique advantaovide our patien
ary level care facmond) “The Royd carries out just t great contribut reports for RHDcause they are raking it hard to fe) “The Lyell Mc
area, and has uners are now abos including an ad
mic disadvantageabetes. We also medical co-morbre fortunate to wcluding homebirtal.”
on and AMOSS
ton) “Frances Pefrom everywher
n the AMOSS stutric conditions. Wrse maternal outultimately helps
bart Hospital: Aftin Obstetrics, St
ellow obstetriciaderably easier wi
AMOSS is an imn women’s healpart of it. e) “I have been cases in that ti
lection on obesimatic heart dises, and am part oively mild diseasatients, somethi
of care, but as a n place, I usuallyfew months. As a, so I believe thtice in our hospby better collaboses of maternal
Southern
gs coordinator f
f specialist with nce 2010. Steve
n Adelaide LocalGynaecologist aost 1 year
erry House: is a p3 beds. We have
eatres, a day surear there were oge of being co-lo
nts with the highcilities of the Roy
yal Hobart Hospion 2000 deliver
tors of cases for D or breast canceare, it does not gforget.” cEwin Hospital:dergone significut 3500 per anndult Intensive Cae, and a significahave a very dive
bidities and a widwork with a Hearth, and to be lin
S
erry House receire in Victoria andudy a number of We believe this wtcomes. We bens to provide our ter four years asteve has steppean. “Over thoseith the introduct
mportant projectth and the Roya
the AMOSS coorime. The workloity. We have hadease study is of pof the AMOSS RHse and good obsing that can be afull-timer and w
y get to hear aba clinical managat involvement pital. Clinical inoration, and themorbidity throu
n States..
or Frances Perry
the Royal Hobare was also the AM
Health Networkat Lyell McEwin H
private obstetrice 6 birthing suitegery unit, a urod
over 3,500 babieocated with the
hest standard of yal Women’s Hoital: is the referrries per year. Wi
AMOSS. So far er. On the otherget lost in the bu
serves the northcant expansion onum, and we areare Unit and a Spant number of perse migrant popde range of expelth Department
nked to the Unive
ves many privatd sometimes inteyears ago and h
work is vital to imefit by reflectionpatients with th
s data collector ad down and hanfour years the t
tion of ‘ObstetriXt with the potentl Hobart Hospita
rdinator at Lyellad has been qud several wome
particular interesHD in Pregnancystetric outcomesa problem in a lawith a variety ofbout potential cger I find it very u
with the AMOSnteractions withe whole process ugh local audits a
..
y House in Victo
rt Hospital and tMOSS data colle
k (NALHN) HeadHospital in Adel
c and surgical hoes, a level 2 nursdynamics procedes born at France
Royal Women’sf private hospitaospital if requiredral hospital for o
With these rather we have encoun
r hand, when a cusy unit, but ten
hern part of the of provided servie supported by apecial Care Nurs
pregnancies are pulation, with anectations and chthat is supporti
versity of Adelaid
te patients requierstate, we comhave managed tmprove maternin on our practicehe best possible and AMOSS stat
nded over that rtask of collectingXTas’, an electrotial to make datal Queen Alexan
l McEwin since Muite manageableen eligible for thst to me as I wo
y advisory groups. Collecting the arge public hospf established in-hcases early on souseful to reviewSS collection hah other disciplinhas encouragedand case review
oria and has bee
the AMOSS stateector from 2010
d of Obstetrics aaide. Simon has
ospital situated sery, a dedicateddure room and aes Perry. Perry s Hospital. This l care whilst havd.”
obstetrics for small numbers
ntered but case for reportinnds to present a
Adelaide ices in recent yea
a range of acute sery. The area is complicated by n attendant ranghallenges aroundve of a range of
de as a research
iring specialized mmenced to capture a broaity care and e and improvingcare.” te representativole to Dr. Glenng the data has onic database anta available for ndra Maternity U
May 2013, and he, possibly becauhe AMOSS under
rked in Alice Sprp. Happily all wo
data involves bpital with limitathouse meetings o data entry ca
w clinical data ens been beneficianes have also bd us to look at o
ws.”
n a
e
nd
in d a
ving
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ars.
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ge d f
and
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TAKING STOCK: THE AUSTRALASIAN MATERNITY OUTCOMES SURVEILLANCE SYSTEM (AMOSS) FIVE YEARS ON
As we enter into the sixth year of the AMOSS surveillance and research system, it’s timely to review where we are and what has changed.
Fittingly, AMOSS was launched at Parliament House Canberra in 2009 - the same year as the Improving Maternity Services in Australia Maternity Services Review Report was released.
Against the backdrop of some of the most significant changes that have occurred in Australian maternity care, where does AMOSS fit? AMOSS objectives are closely aligned to key recommendations of the Maternity Services Review report, which urged improved national data collection on maternal morbidity. AMOSS has achieved this for select, specific rare and severe conditions but only because of the support of the wider maternity community, RANZCOG, ACM and SOMANZ
In our work to streamline quality data collection AMOSS has forged strong networks to support quality data collection. Our advisory groups provide critical formal avenues for dialogue and consultation. The bedrock of our study remains our AMOSS site coordinators - midwives and obstetricians, maternal-fetal specialists and many others - who provide data to and consultation with AMOSS. Of course, AMOSS is one part of a critical nexus of initiatives that work to improve maternity care in Australia and New Zealand.
We have been guided by and worked closely with Australian jurisdictional maternal and perinatal committees and Colleges. Our partnership with New Zealand under the auspices of the Perinatal and Maternal Mortality Review Committee (PMMRC) has provided another critical dimension to the system. However, another dimension to the AMOSS networks is a strengthening of collaboration across disciplines. The Maternity Services Review Report called for “guidelines to support collaborative multidisciplinary care”. In our efforts to collect data on serious events in pregnancy, we have needed to expand beyond perinatal data capture systems to ensure optimal surveillance and quality data. For instance, in the rheumatic heart disease study, RHD Control Register teams and cardiac care now work with AMOSS coordinators to ensure women are included on our study. In 2013 a data item was included on the Australia and New Zealand Breast Surgeons Quality Audit, and networks are being formed with groups such as Breast Cancer Network Australia and Breast Cancer Nurses to ensure women are included in our study. There is recognition that good data must include perspectives of the women who experience these conditions: our recent studies include a qualitative component, and our advisory groups benefit from the input of women who are impacted by serious morbidity in pregnancy.
The system created by AMOSS has created its own challenges! As we have grown, the data collection system has outgrown itself and we anticipate ‘AMOSS Mark II’ to be fully released by mid-year, which will – apart from providing a more robust system – will give better reporting to hospitals. Data analysis in progress for several of our studies will provide our findings back to those who care for women who experience these rare and often devastating conditions in pregnancy.
AMOSS has an important educational role, both direct and indirect. The inclusion of specific conditions raises awareness, and the process of data collection supports specific knowledge – acknowledged in CPD points for midwives, provided by the Australian College of Midwives. More broadly, it fosters a better awareness of the overall burden of morbidity in maternity settings.
Once again, we would like to acknowledge and celebrate that AMOSS is a national maternity collaboration which in itself is an achievement. It is due to the enthusiasm and drive of maternity and other health care disciplines in their efforts to make a difference and improve care of women during pregnancy that AMOSS continues.
Professor Elizabeth Sullivan Principal Investigator
Newsletter 21 - April 2014
Thanks to the following hospitals that have responded to AMOSS over the last three months
All three months Albany Regional Hospital Alice Springs Hospital Angliss Hospital Ararat Campus Armadale Health Service Armidale Hospital Ashford Hospital Atherton Tableland Hospital Auburn Hospital Auckland City Hospital Ayr Hospital Bairnsdale Regional Health Service Ballarat Health Services Bankstown-Lidcombe Hospital Bathurst Base Hospital Bay of Plenty DHB Bega Hospital Benalla & District Memorial Hospital Bendigo Health Care Group Bentley Health Service Biloela Hospital Blacktown Hospital Bowral Hospital Box Hill Hospital Bridgetown District Hospital Broken Hill Health Service Broome District Hospital Bunbury Regional Hospital Bundaberg Hospital Burnside War Memorial Hospital Busselton District Hospital Caboolture Hospital Cairns Base Hospital Cairns Private Hospital Calvary Health Care Calvary Health Care ACT Calvary Health Care Riverina Campbelltown Hospital Canterbury Hospital Casino Hospital Central Gippsland Health Service Charleville Hospital Chinchilla Hospital Christchurch Women’s Hospital Coffs Harbour Base Hospital Cohuna District Hospital Colac Area Health Collie District Hospital Cooma Hospital Cootamundra Hospital Cowra Health Service Dandenong Hospital Deniliquin Hospital Derby Regional Health Djerriwarrh Health Services Dubbo Base Hospital Dunedin Hospital Echuca Regional Health Emerald Hospital Esperance District Hospital Fairfield Hospital Figtree Private Hospital Flinders Medical Centre Flinders Private Hospital Forbes Hospital Frances Perry House Frankston Hospital Gawler Health Service Geraldton Regional Hospital Gippsland Southern Health Service Gisborne Hospital Gladstone Hospital Glen Innes Hospital Glengarry Private Hospital Gold Coast Hospital Goondiwindi Hospital Gosford Hospital Goulburn Base Hospital Gove District Hospital East Arnhem Grafton Base Hospital Gympie Hospital Hawke’s Bay Hospital Hawkesbury District Health Service Hervey Bay Hospital Hobart Private Hospital Hornsby Ku-ring-gai Hospital Hurstville Private Hospital Innisfail Hospital Inverell Health Service Jessie McPherson Private Hospital John Flynn Gold Coast Private Hospital Kaleeya Hospital Kapunda Hospital Kareena Private Hospital Katanning District Hospital
Katherine Hospital Kerang & District Hospital King Edward Memorial Hospital For Women Kingaroy Hospital Kununurra District Hospital Kyabram District Health Service Latrobe Regional Hospital Launceston General Hospital Lismore Base Hospital Liverpool Hospital Logan Hospital Longreach Hospital Loxton Hospital Complex Lyell McEwin Hospital Mackay Base Hospital Manning Base Hospital Mansfield District Hospital Mareeba Hospital Margaret River District Hospital Maryborough District Health Service Mater Misericordiae Hospital Rockhampton Mater Mothers Hospital Brisbane Mater Private Hospital Redland Mercy Hospital for Women Mercy Hospital Mount Lawley Middlemore Hospital Mildura Base Hospital Milton-Ulladulla Hospital Mitcham Private Hospital Monash Birth Centre Moree Hospital Moruya District Hospital Mount Barker and Districts Soldiers Memorial Hospital Mount Gambier & District Health Services Mount Isa Hospital Mt Waverley Private Hospital Mudgee District Hospital Mullumbimby Hospital Murray Bridge Soldiers' Memorial Hospital Inc Murwillumbah District Hospital Muswellbrook District Hospital Nambour General Naracoorte Health Services Narrabri Hospital Narrandera Hospital Narrogin Regional Hospital Nelson Hospital Nepean Hospital Nepean Private Hospital Newcastle Private Hospital North Eastern Community Hospital North Gosford Private Hospital North Shore Private Hospital North West Private Hospital Burnie Campus Northam Regional Hospital Northeast Health Wangaratta Northern Beaches Maternity Services Northpark Private Hospital Norwest Private Hospital Orange Base Hospital Osborne Park Hospital Parkes Hospital Peel Health Campus Pindara Private Hospital Port Augusta Hospital & Regional Health Services Port Macquarie Base Hospital Port Pirie Regional Health Service Portland District Health Proserpine Hospital Queanbeyan District Hospital & Health Service Redland Hospital Riverland Regional Health Service Rockhampton Hospital Rockingham General Hospital Roma Hospital Royal Brisbane and Women's Hospital Royal Darwin Hospital Royal Hobart Hospital Royal Hospital for Women Royal North Shore Hospital (RNSH) Royal Prince Alfred Hospital (RPAH) Ryde Hospital Sandringham Hospital Scott Memorial Hospital Shoalhaven District Memorial Hospital South Coast District Hospital South Gippsland Hospital (Foster) South West Health Care (Camperdown) Southern Flinders Health - Crystal Brook Campus Southland Hospital St Andrew’s Ipswich Private Hospital St George Hospital St John of God Geelong St John of God Geraldton St John of God Health Care Ballarat
St John of God Health Care Berwick St John of God Health Care Bunbury St John of God Health Care Subiaco St John of God Hospital Bendigo St John of God Hospital Murdoch St Vincents Private Hospital Stanthorpe Hospital Stawell Regional Health Sunshine Hospital Sutherland Hospital Swan Hill District Hospital Swan Kalamunda Health Service Sydney Adventist Hospital Sydney Southwest Private Hospital Tamworth Rural Referral Hospital Tanunda Hospital Taranaki Base Hospital Temora District Hospital The Bays Hospital Mornington The Canberra Hospital The Kilmore & District Hospital The Mater Hospital Sydney The Royal Women's Hospital The Sunshine Coast Private Hospital The Wesley Hospital The Whyalla Hospital & Health Services Thursday Island Hospital Timaru Hospital Townsville Hospital WA Country Health Service - Goldfields Wagga Wagga Base Hospital Waikato Hospital Waikerie Health Services Wairarapa Hospital Wallaroo Hospital Warwick Hospital Werribee Mercy Hospital West Gippsland Hospital Westmead Hospital Whanganui Hospital Whangarei Hospital Wimmera Health Care Group (Horsham) Wollongong Hospital Women's and Children's Hospital, Adelaide Wonthaggi Hospital (Bass Coast Regional Health) Wyong Hospital Yarrawonga District Health Service Young Hospital Two months Albury Wodonga Health Attadale Private Hospital Carnarvon Regional Hospital Casey Hospital Dalby Hospital Darwin Private Hospital Epworth Freemasons Hospital Gladstone Mater Hospital Griffith Base Hospital Gunnedah Hospital Hutt Valley Hospital Joondalup Health Campus Kalgoorlie Regional Hospital Kempsey District Hospital Macksville Hospital Palmerston North Hospital Port Lincoln Health Services Inc Redcliffe Hospital Rotorua Hospital Singleton District Hospital South West Health Care (Warrnambool) St George Hospital Queensland St George Private Hospital St Vincent's & Mercy Private Hospital The Northern Hospital The Tweed Hospital Toowoomba Base Hospital Tumut Hospital Westmead Private Hospital One month Calvary Health Private Goulburn Valley Health Peninsula Private Hospital Sunnybank Private Hospital Wellington Hospital
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SS data collectionncreased numberputting the old inausing delays whystem is using sliifferent ways of cd improve the spm both for data conal functions fo
ctical terms it meer and easier for collectors and thee.
ew system is almlive over the nexfor you?
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detailed informaded when the new
ant to thank you nce and support dree to contact thuestions.
colates and tair Haslam of Wanding to the AMOing cases and Mate Hospital Burniterrific at responhly emails.
OSS conditions
ent studies mniotic fluid embestational breast ceumatic heart disa praevia (April
eceived an infrastsity of NSW to ren system. Improvr of conditions unnfrastructure unden completing suightly different tecapturing case daeed and perform
collectors, as wellor use by the AMO
eans it should maour committed v
e data collected e
most complete anxt month. So wha
stem will remain MOSS website. s will look and feenk it’s a huge impd for general infoon will remain thto view and comp
ose from the old the new system.d case will appea
show as closed. Oo the survey for yhis link will be dirnd you can comp
a slight delay to tor the Massive Obudy so that it canthe new system.
ation and instructw system goes liv
for your all yourduring this redeve AMOSS office if
thanks... ikato Hospital (NOSS monthly emaarilyn Steers of Noe Campus (Tas) wding promptly to
s
olism (since 2010cancer (2013 - Jusease (2013-20142013 – April 201
haemorrhage (20
s ry embolism (cea
mission MI > 50) ectomy
ly 18 tructure develop the ed reporting
nder study der strain urveys. The echnology ata. This
mance of the l as adding OSS office.
ake life volunteer even more
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unchanged
el slightly provement. ormation he same. plete cases
system) will . A ar with its Open cases you to click rectly into plete the
he start of bstetric be
tions will be ve.
r feedback, velopment. f you have
NZ) for ails and orth West who has o the AMOSS
0) ne 14) 4) 4) 14)
ased 31
SpotlighThe Data Coll
Simone Quintodata collector sDr Stephen Rayrepresentative until the end oDr Simon Kaneis a Consultantbeen a data co
The Hospitals
(Simone QuintMelbourne, thepostnatal unit, surgical/materHouse has the allows us to proaccess to tertia(Dr Steve RaymTasmania, andfind we are notcontributed no does occur, bechigh profile, ma(Dr Simon Kanemetropolitan aBirthing numbecare specialtiesof socioeconomobesity and diaof interesting mbirthing. We arcare models incteaching hospit
Data Collectio
(Simone QuintObstetric care fparticipation inrange of obstetdecrease adverprocesses that The Royal HobStaff Specialist Blanchette, a febecome considclinical record. improvement inis glad to be a p(Dr Simon Kanereported eight missed the collcare. The rheumfor many yearshave had relatiaware of the paon continuity omechanisms inspread over a fand processes,obstetric practstrengthened bsignificant caus
ht on the lectors
on is the bookingsince 2010 ymond is a staff for Tasmania sif 2013
e is the Northernt Obstetrician & ollectors for almo
s
ton) “Frances Pee Hospital has 93 3 operating the
rnity unit. Last yeunique advantaovide our patien
ary level care facmond) “The Royd carries out just t great contribut reports for RHDcause they are raking it hard to fe) “The Lyell Mc
area, and has uners are now abos including an ad
mic disadvantageabetes. We also medical co-morbre fortunate to wcluding homebirtal.”
on and AMOSS
ton) “Frances Pefrom everywher
n the AMOSS stutric conditions. Wrse maternal outultimately helps
bart Hospital: Aftin Obstetrics, St
ellow obstetriciaderably easier wi
AMOSS is an imn women’s healpart of it. e) “I have been cases in that ti
lection on obesimatic heart dises, and am part oively mild diseasatients, somethi
of care, but as a n place, I usuallyfew months. As a, so I believe thtice in our hospby better collaboses of maternal
Southern
gs coordinator f
f specialist with nce 2010. Steve
n Adelaide LocalGynaecologist aost 1 year
erry House: is a p3 beds. We have
eatres, a day surear there were oge of being co-lo
nts with the highcilities of the Roy
yal Hobart Hospion 2000 deliver
tors of cases for D or breast canceare, it does not gforget.” cEwin Hospital:dergone significut 3500 per anndult Intensive Cae, and a significahave a very dive
bidities and a widwork with a Hearth, and to be lin
S
erry House receire in Victoria andudy a number of We believe this wtcomes. We bens to provide our ter four years asteve has steppean. “Over thoseith the introduct
mportant projectth and the Roya
the AMOSS coorime. The workloity. We have hadease study is of pof the AMOSS RHse and good obsing that can be afull-timer and w
y get to hear aba clinical managat involvement pital. Clinical inoration, and themorbidity throu
n States..
or Frances Perry
the Royal Hobare was also the AM
Health Networkat Lyell McEwin H
private obstetrice 6 birthing suitegery unit, a urod
over 3,500 babieocated with the
hest standard of yal Women’s Hoital: is the referrries per year. Wi
AMOSS. So far er. On the otherget lost in the bu
serves the northcant expansion onum, and we areare Unit and a Spant number of perse migrant popde range of expelth Department
nked to the Unive
ves many privatd sometimes inteyears ago and h
work is vital to imefit by reflectionpatients with th
s data collector ad down and hanfour years the t
tion of ‘ObstetriXt with the potentl Hobart Hospita
rdinator at Lyellad has been qud several wome
particular interesHD in Pregnancystetric outcomesa problem in a lawith a variety ofbout potential cger I find it very u
with the AMOSnteractions withe whole process ugh local audits a
..
y House in Victo
rt Hospital and tMOSS data colle
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Thanks to the following hospitals that have responded to AMOSS over the last three months
All three months Albany Regional Hospital Alice Springs Hospital Angliss Hospital Ararat Campus Armadale Health Service Armidale Hospital Ashford Hospital Atherton Tableland Hospital Auburn Hospital Auckland City Hospital Ayr Hospital Bairnsdale Regional Health Service Ballarat Health Services Bankstown-Lidcombe Hospital Bathurst Base Hospital Bay of Plenty DHB Bega Hospital Benalla & District Memorial Hospital Bendigo Health Care Group Bentley Health Service Biloela Hospital Blacktown Hospital Bowral Hospital Box Hill Hospital Bridgetown District Hospital Broken Hill Health Service Broome District Hospital Bunbury Regional Hospital Bundaberg Hospital Burnside War Memorial Hospital Busselton District Hospital Caboolture Hospital Cairns Base Hospital Cairns Private Hospital Calvary Health Care Calvary Health Care ACT Calvary Health Care Riverina Campbelltown Hospital Canterbury Hospital Casino Hospital Central Gippsland Health Service Charleville Hospital Chinchilla Hospital Christchurch Women’s Hospital Coffs Harbour Base Hospital Cohuna District Hospital Colac Area Health Collie District Hospital Cooma Hospital Cootamundra Hospital Cowra Health Service Dandenong Hospital Deniliquin Hospital Derby Regional Health Djerriwarrh Health Services Dubbo Base Hospital Dunedin Hospital Echuca Regional Health Emerald Hospital Esperance District Hospital Fairfield Hospital Figtree Private Hospital Flinders Medical Centre Flinders Private Hospital Forbes Hospital Frances Perry House Frankston Hospital Gawler Health Service Geraldton Regional Hospital Gippsland Southern Health Service Gisborne Hospital Gladstone Hospital Glen Innes Hospital Glengarry Private Hospital Gold Coast Hospital Goondiwindi Hospital Gosford Hospital Goulburn Base Hospital Gove District Hospital East Arnhem Grafton Base Hospital Gympie Hospital Hawke’s Bay Hospital Hawkesbury District Health Service Hervey Bay Hospital Hobart Private Hospital Hornsby Ku-ring-gai Hospital Hurstville Private Hospital Innisfail Hospital Inverell Health Service Jessie McPherson Private Hospital John Flynn Gold Coast Private Hospital Kaleeya Hospital Kapunda Hospital Kareena Private Hospital Katanning District Hospital
Katherine Hospital Kerang & District Hospital King Edward Memorial Hospital For Women Kingaroy Hospital Kununurra District Hospital Kyabram District Health Service Latrobe Regional Hospital Launceston General Hospital Lismore Base Hospital Liverpool Hospital Logan Hospital Longreach Hospital Loxton Hospital Complex Lyell McEwin Hospital Mackay Base Hospital Manning Base Hospital Mansfield District Hospital Mareeba Hospital Margaret River District Hospital Maryborough District Health Service Mater Misericordiae Hospital Rockhampton Mater Mothers Hospital Brisbane Mater Private Hospital Redland Mercy Hospital for Women Mercy Hospital Mount Lawley Middlemore Hospital Mildura Base Hospital Milton-Ulladulla Hospital Mitcham Private Hospital Monash Birth Centre Moree Hospital Moruya District Hospital Mount Barker and Districts Soldiers Memorial Hospital Mount Gambier & District Health Services Mount Isa Hospital Mt Waverley Private Hospital Mudgee District Hospital Mullumbimby Hospital Murray Bridge Soldiers' Memorial Hospital Inc Murwillumbah District Hospital Muswellbrook District Hospital Nambour General Naracoorte Health Services Narrabri Hospital Narrandera Hospital Narrogin Regional Hospital Nelson Hospital Nepean Hospital Nepean Private Hospital Newcastle Private Hospital North Eastern Community Hospital North Gosford Private Hospital North Shore Private Hospital North West Private Hospital Burnie Campus Northam Regional Hospital Northeast Health Wangaratta Northern Beaches Maternity Services Northpark Private Hospital Norwest Private Hospital Orange Base Hospital Osborne Park Hospital Parkes Hospital Peel Health Campus Pindara Private Hospital Port Augusta Hospital & Regional Health Services Port Macquarie Base Hospital Port Pirie Regional Health Service Portland District Health Proserpine Hospital Queanbeyan District Hospital & Health Service Redland Hospital Riverland Regional Health Service Rockhampton Hospital Rockingham General Hospital Roma Hospital Royal Brisbane and Women's Hospital Royal Darwin Hospital Royal Hobart Hospital Royal Hospital for Women Royal North Shore Hospital (RNSH) Royal Prince Alfred Hospital (RPAH) Ryde Hospital Sandringham Hospital Scott Memorial Hospital Shoalhaven District Memorial Hospital South Coast District Hospital South Gippsland Hospital (Foster) South West Health Care (Camperdown) Southern Flinders Health - Crystal Brook Campus Southland Hospital St Andrew’s Ipswich Private Hospital St George Hospital St John of God Geelong St John of God Geraldton St John of God Health Care Ballarat
St John of God Health Care Berwick St John of God Health Care Bunbury St John of God Health Care Subiaco St John of God Hospital Bendigo St John of God Hospital Murdoch St Vincents Private Hospital Stanthorpe Hospital Stawell Regional Health Sunshine Hospital Sutherland Hospital Swan Hill District Hospital Swan Kalamunda Health Service Sydney Adventist Hospital Sydney Southwest Private Hospital Tamworth Rural Referral Hospital Tanunda Hospital Taranaki Base Hospital Temora District Hospital The Bays Hospital Mornington The Canberra Hospital The Kilmore & District Hospital The Mater Hospital Sydney The Royal Women's Hospital The Sunshine Coast Private Hospital The Wesley Hospital The Whyalla Hospital & Health Services Thursday Island Hospital Timaru Hospital Townsville Hospital WA Country Health Service - Goldfields Wagga Wagga Base Hospital Waikato Hospital Waikerie Health Services Wairarapa Hospital Wallaroo Hospital Warwick Hospital Werribee Mercy Hospital West Gippsland Hospital Westmead Hospital Whanganui Hospital Whangarei Hospital Wimmera Health Care Group (Horsham) Wollongong Hospital Women's and Children's Hospital, Adelaide Wonthaggi Hospital (Bass Coast Regional Health) Wyong Hospital Yarrawonga District Health Service Young Hospital Two months Albury Wodonga Health Attadale Private Hospital Carnarvon Regional Hospital Casey Hospital Dalby Hospital Darwin Private Hospital Epworth Freemasons Hospital Gladstone Mater Hospital Griffith Base Hospital Gunnedah Hospital Hutt Valley Hospital Joondalup Health Campus Kalgoorlie Regional Hospital Kempsey District Hospital Macksville Hospital Palmerston North Hospital Port Lincoln Health Services Inc Redcliffe Hospital Rotorua Hospital Singleton District Hospital South West Health Care (Warrnambool) St George Hospital Queensland St George Private Hospital St Vincent's & Mercy Private Hospital The Northern Hospital The Tweed Hospital Toowoomba Base Hospital Tumut Hospital Westmead Private Hospital One month Calvary Health Private Goulburn Valley Health Peninsula Private Hospital Sunnybank Private Hospital Wellington Hospital
Thanks to the following hospitals that have responded to AMOSS over the last three months
All three months Albany Regional Hospital Alice Springs Hospital Angliss Hospital Ararat Campus Armadale Health Service Armidale Hospital Ashford Hospital Atherton Tableland Hospital Auburn Hospital Auckland City Hospital Ayr Hospital Bairnsdale Regional Health Service Ballarat Health Services Bankstown-Lidcombe Hospital Bathurst Base Hospital Bay of Plenty DHB Bega Hospital Benalla & District Memorial Hospital Bendigo Health Care Group Bentley Health Service Biloela Hospital Blacktown Hospital Bowral Hospital Box Hill Hospital Bridgetown District Hospital Broken Hill Health Service Broome District Hospital Bunbury Regional Hospital Bundaberg Hospital Burnside War Memorial Hospital Busselton District Hospital Caboolture Hospital Cairns Base Hospital Cairns Private Hospital Calvary Health Care Calvary Health Care ACT Calvary Health Care Riverina Campbelltown Hospital Canterbury Hospital Casino Hospital Central Gippsland Health Service Charleville Hospital Chinchilla Hospital Christchurch Women’s Hospital Coffs Harbour Base Hospital Cohuna District Hospital Colac Area Health Collie District Hospital Cooma Hospital Cootamundra Hospital Cowra Health Service Dandenong Hospital Deniliquin Hospital Derby Regional Health Djerriwarrh Health Services Dubbo Base Hospital Dunedin Hospital Echuca Regional Health Emerald Hospital Esperance District Hospital Fairfield Hospital Figtree Private Hospital Flinders Medical Centre Flinders Private Hospital Forbes Hospital Frances Perry House Frankston Hospital Gawler Health Service Geraldton Regional Hospital Gippsland Southern Health Service Gisborne Hospital Gladstone Hospital Glen Innes Hospital Glengarry Private Hospital Gold Coast Hospital Goondiwindi Hospital Gosford Hospital Goulburn Base Hospital Gove District Hospital East Arnhem Grafton Base Hospital Gympie Hospital Hawke’s Bay Hospital Hawkesbury District Health Service Hervey Bay Hospital Hobart Private Hospital Hornsby Ku-ring-gai Hospital Hurstville Private Hospital Innisfail Hospital Inverell Health Service Jessie McPherson Private Hospital John Flynn Gold Coast Private Hospital Kaleeya Hospital Kapunda Hospital Kareena Private Hospital Katanning District Hospital
Katherine Hospital Kerang & District Hospital King Edward Memorial Hospital For Women Kingaroy Hospital Kununurra District Hospital Kyabram District Health Service Latrobe Regional Hospital Launceston General Hospital Lismore Base Hospital Liverpool Hospital Logan Hospital Longreach Hospital Loxton Hospital Complex Lyell McEwin Hospital Mackay Base Hospital Manning Base Hospital Mansfield District Hospital Mareeba Hospital Margaret River District Hospital Maryborough District Health Service Mater Misericordiae Hospital Rockhampton Mater Mothers Hospital Brisbane Mater Private Hospital Redland Mercy Hospital for Women Mercy Hospital Mount Lawley Middlemore Hospital Mildura Base Hospital Milton-Ulladulla Hospital Mitcham Private Hospital Monash Birth Centre Moree Hospital Moruya District Hospital Mount Barker and Districts Soldiers Memorial Hospital Mount Gambier & District Health Services Mount Isa Hospital Mt Waverley Private Hospital Mudgee District Hospital Mullumbimby Hospital Murray Bridge Soldiers' Memorial Hospital Inc Murwillumbah District Hospital Muswellbrook District Hospital Nambour General Naracoorte Health Services Narrabri Hospital Narrandera Hospital Narrogin Regional Hospital Nelson Hospital Nepean Hospital Nepean Private Hospital Newcastle Private Hospital North Eastern Community Hospital North Gosford Private Hospital North Shore Private Hospital North West Private Hospital Burnie Campus Northam Regional Hospital Northeast Health Wangaratta Northern Beaches Maternity Services Northpark Private Hospital Norwest Private Hospital Orange Base Hospital Osborne Park Hospital Parkes Hospital Peel Health Campus Pindara Private Hospital Port Augusta Hospital & Regional Health Services Port Macquarie Base Hospital Port Pirie Regional Health Service Portland District Health Proserpine Hospital Queanbeyan District Hospital & Health Service Redland Hospital Riverland Regional Health Service Rockhampton Hospital Rockingham General Hospital Roma Hospital Royal Brisbane and Women's Hospital Royal Darwin Hospital Royal Hobart Hospital Royal Hospital for Women Royal North Shore Hospital (RNSH) Royal Prince Alfred Hospital (RPAH) Ryde Hospital Sandringham Hospital Scott Memorial Hospital Shoalhaven District Memorial Hospital South Coast District Hospital South Gippsland Hospital (Foster) South West Health Care (Camperdown) Southern Flinders Health - Crystal Brook Campus Southland Hospital St Andrew’s Ipswich Private Hospital St George Hospital St John of God Geelong St John of God Geraldton St John of God Health Care Ballarat
St John of God Health Care Berwick St John of God Health Care Bunbury St John of God Health Care Subiaco St John of God Hospital Bendigo St John of God Hospital Murdoch St Vincents Private Hospital Stanthorpe Hospital Stawell Regional Health Sunshine Hospital Sutherland Hospital Swan Hill District Hospital Swan Kalamunda Health Service Sydney Adventist Hospital Sydney Southwest Private Hospital Tamworth Rural Referral Hospital Tanunda Hospital Taranaki Base Hospital Temora District Hospital The Bays Hospital Mornington The Canberra Hospital The Kilmore & District Hospital The Mater Hospital Sydney The Royal Women's Hospital The Sunshine Coast Private Hospital The Wesley Hospital The Whyalla Hospital & Health Services Thursday Island Hospital Timaru Hospital Townsville Hospital WA Country Health Service - Goldfields Wagga Wagga Base Hospital Waikato Hospital Waikerie Health Services Wairarapa Hospital Wallaroo Hospital Warwick Hospital Werribee Mercy Hospital West Gippsland Hospital Westmead Hospital Whanganui Hospital Whangarei Hospital Wimmera Health Care Group (Horsham) Wollongong Hospital Women's and Children's Hospital, Adelaide Wonthaggi Hospital (Bass Coast Regional Health) Wyong Hospital Yarrawonga District Health Service Young Hospital Two months Albury Wodonga Health Attadale Private Hospital Carnarvon Regional Hospital Casey Hospital Dalby Hospital Darwin Private Hospital Epworth Freemasons Hospital Gladstone Mater Hospital Griffith Base Hospital Gunnedah Hospital Hutt Valley Hospital Joondalup Health Campus Kalgoorlie Regional Hospital Kempsey District Hospital Macksville Hospital Palmerston North Hospital Port Lincoln Health Services Inc Redcliffe Hospital Rotorua Hospital Singleton District Hospital South West Health Care (Warrnambool) St George Hospital Queensland St George Private Hospital St Vincent's & Mercy Private Hospital The Northern Hospital The Tweed Hospital Toowoomba Base Hospital Tumut Hospital Westmead Private Hospital One month Calvary Health Private Goulburn Valley Health Peninsula Private Hospital Sunnybank Private Hospital Wellington Hospital
