Original Article

Introducing a new service of a midwife-led telephone follow-up clinic for 3a & 3b Obstetric Anal Sphincter Injury:retrospective service evaluation and patients' satisfaction survey

S. Shawer 1, S. Innayat 1, H. Hutchinson 2, P. Ballard 2, A. Khunda 2

1 North Tees and Hartlepool NHS Foundation Trust,
2 South Tees NHS Foundation Trust

Diakonissenkrankenhaus Flensburg, Flensburg, Germany


Background Most patients with 3a and 3b perineal tears will be asymptomatic. The need for all patients to attend a hospital appointment can be questioned. We set up a midwife-led telephone review clinic for such injuries. We aim to evaluate this service by auditing it and also by analyzing patients’ satisfaction through a patient satisfaction survey.

Methods We performed retrospective analysis of the patients’ notes over 18 months. We evaluated this service by auditing its adherence to specified standards within the local guidelines and by performing a patients’ satisfaction survey of the new service via anonymized postal Friends and Family test.

Results We looked at 66 sets of notes, of which 48 had datasets with complete clinical/symptomatic data. 14/21 3a and 17/27 3b OASI were asymptomatic and discharged. Only 3 patients with 3a tear and 6 with 3b tear were referred to the consultant-led clinic. From 89 patients who had a midwife-led telephone clinic, 21 responded to the postal survey (23.6%). Two had not received their telephone appointment. 17/19 (89.4%) responded very good or good to the question ‘how well do you think your questions and concerns were addressed’. 16/19 (84.2%) responded extremely likely or likely to the question ’how likely are you to recommend this service to friends and family’.

Conclusions A midwife-led telephone follow-up clinic for patients who sustained 3a and 3b tears seems to be an acceptable service for these patients with high satisfaction rate. We believe that this service has the potential to save time and resources for both patients and healthcare providers.

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