BIRTHRATE ACUITY SYSTEM:

During 2007 Birthrate Plus® (BR+) developed a means for midwives to assess their "real time" workload in the delivery suite arising from the numbers of women needing care, and their condition on admission and during the processes of labour and delivery.

This was termed a measure of "Acuity" and an outline of the method is given below.

The initial methodology was validated by further use in the maternity services in Wales co-ordinated by Marie Washbrook.

Briefly the system is based upon an adaptation of the same clinical indicators for intrapartum care used in the well established workforce planning system Birthrate Plus®.

The scoring has been changed to enable the BR+ classification system to become a predictive/prospective tool rather than the retrospective assessment of process and outcome of labour used in Birthrate Plus®. By this mean, an hour by hour assessment can be produced of the numbers of midwives needed in the delivery suite to meet the needs of the women, based on the minimum standard of one to one care for all clients and increased ratios of midwife time for women in the higher need categories.  This provides an assessment on admission of where a woman fits within the BR+ Categories I –V which are cited in Safer Childbirth (RCOG 2007) and Staffing Guidance (RCM 2009), and alerts midwives when events during labour move her into a higher category and increased need of midwife support.