The National Obstetric Anaesthesia Group Douglas Mein I am a SMO at Capital and Coast DHB. And I am the Chair of the National Obstetric Anaesthesia group or NOA group. We all know Anaesthesia is now very safe but I suspect we all believe it can be safer. Personally I think this could happen through two ways. One; better integration between monitoring and human factors (sadly we have just bought Dreager ... So that put this off for 10 years for us) And Two better communication. By communication I mean that in the widest possible sense. From individually with patients through to immediate team work and the wider hospital team to the National level. In NZ we only have 20 DHBs, so 20 people in one room can represent anaesthesia for all of NZ. The NOA Group has been established in order to improve communication and team work between the Obstetric Anaesthetist within New Zealand; with the aim of improving care of women. WE HAVE ALREADY ACHIEVED THIS.

This is what I found myself trying to invent as a Clinical Lead.... Even in a large department others do not share the same interests as you.

Purpose to provide collegial support to one another “This collegial team is especially important for those of us in smaller environments.” “Despite working in a supportive department, I’m the only one with an interest in this area and it is such a relief to not feel so isolated” Groups function well when they know their purpose is to help each other out. The following bullet points are taken from our terms of reference. The quotes are taken from emails I have received when I asked for comments from the group on how it is going. We have done this. Even simple things like all having access to each others email addresses and telephone numbers is useful. But face to face contact is what builds relationships.

Purpose to strengthen regional clinical leadership in Obstetrics Anaesthesia “I feel like my membership of this group gives me more confidence in my role as obstetric lead at my DHB” “it has also helped to decrease some stressors by realising that a lot of issues are shared” Sadly most of us on the group have more than 20 years experience, between us we have way over 400 years experience. We have done this. The group is developing well.

Purpose to provide a forum for the sharing of ideas, information, guidelines and educational material “The networking aspect for collaboration of practices and information as well as discussion and dissemination of new ideas is invaluable” Fentanyl and Morphine Recently Tramadol issues

Purpose to provide a forum for discussion and resolution of issues of common concern across the regions DHBs “It is also reassuring that the same problems occur NZ-wide!”

Purpose to provide a forum for discussion and resolution of issues of common concern across the regions DHBs “I feel the most vital role we can have is in either making sure MCIS does not exist or if it must that it is a safe system” “we can hopefully prevent further maternal morbidity from its implementation / expansion”

Old spice was the first after shave I ever tried.

Purpose to promote consistent approaches across the District Health Boards (DHBs) where appropriate We are doing this by sharing guidelines and discussing common concerns. The plan though is not that we all do exactly the same thing.

Purpose to consider joint audit and research opportunities Not really there on this one, we have done a couple surveys of practice e.g. post op analgesia and epidural training for midwives This may be something that develops

Purpose to act as a forum to discuss morbidity and mortality cases We have done a couple of case presentations but have previous meetings have been quite full and we are not doing this every time. I am not sure where we will head with this.

The National Obstetric Anaesthesia Group “an effective way for us to improve care of our women by learning from one another” “through it’s inception and actions is resulting in improved care of our obstetric patients”