Table 2 Implementation strategies operationalised across three study arms

Set-up

Heads of midwifery/clinical directors select one obstetrician and one midwife to take on the OASI QI Lead role (informed by a role description)

Identify and prepare champions; facilitation; clinical supervision

X

X

X

OASI QI Leads get 1 day/month of protected time to dedicate to OASI-CB sustainability in own unit and to support buddy unit

Fund & contract for the clinical innovation

X

Launch

OASI QI Leads prepared for external facilitator (‘buddy’) role during virtual skills development days organised by clinical and implementation experts (Project Team)

Recruit, designate and train for leadership

X

OASI QI Leads receive the Implementation Toolkit

Develop an implementation blueprint; use educational materials

X

X

X

OASI QI Leads paired up with and introduced to their ‘buddies’

Create a learning collaborative

X

Throughout the study period

OASI QI Leads engage with their ‘buddies’ on a monthly basis (minimum) to seek implementation guidance

Provide local technical assistance; shadow other experts

X

OASI QI Leads to receive centralised support from clinical and implementation experts (Project Team) via monthly advisory meetings

Centralise technical assistance; use an implementation advisor; provide ongoing consultation; promote network weaving; organize clinician implementation team meetings

X

Monthly contact between Project Team and heads of midwifery/ clinical directors to encourage senior buy-in from key members of staff within unit i.e. Labour ward lead, Band 7 labour ward co-ordinators, Patient Safety Leads, QI team etc. and to introduce the OASI-CB into local guidelines and mandatory training / induction packages for new staff (obstetricians and midwives)

Involve executive boards; mandate change/ create or change credentialing and/or licensure standards

X