Growth Assessment Protocol (GAP)
The PI has put together a comprehensive programme which is offered to units already using the GROW software
and new units who now want to implement GROW. The following links give details of the programme:
The following details the PI Terms of Service:

Current users 
New users  
Terms of service 

GAP is based on three key elements:
  1. Implementation of evidence based protocols and guidelines
  2. Training and accreditation of all staff involved in clinical care
  3. Rolling audit and benchmarking of performance
  GAP Programme

Main elements are set out in MIDIRS

Fundal Height Measurement - click here for video demonstration.

GAP training - dates of forthcoming workshops are listed here.

GAP uptake - click here for a list of UK Trusts and Health Boards

Lecture - click here to view a presentation by Prof Jason Gardosi on Preventing Stillbirth: A National Campaign (24 minutes) at the MMB Conference 1/7/2016


Rationale      
• Most 'unexplained' stillbirths were growth restricted   • Customised charts and appropriate protocols should be used  
• Most stillbirths with IUGR are avoidable   • Standardised FH measurement and referral improves detection    
• A/N detection improves outcome and reduces SB   • In high risk pregnancy, serial scans improve detection  

Effect on Stillbirth

A co-ordinated growth assessment programme has reduced ONS stillbirth rates in three English regions with high uptake (West Midlands, Yorkshire & The Humber, North East). For detailed analysis, see BMJ Open 2013 and J Public Health 2014

The reduction is mainly in stillbirths with IUGR

The Times Leading Article

 
ONS stillbirth rates 2008-2012
in high (red) vs low (blue) uptake Regions
 

To date, just under 80% of Trusts and Health Boards in the UK have implemented the GAP Programme. The regional, then national roll-out is mirrored by ONS stillbirth rates in England, which have seen a year-on-year reduction to their lowest ever levels.

   Perinatal Institute wins 2013 Patient Safety Award for Clinical Leadership, for implementing West Midlands stillbirth prevention programme
   Perinatal Institute wins 2014 Patient Safety Award for national roll-out of the GAP - Education and Training Programme
   Perinatal Institute wins 2015 Patient Safety Award for improving safety in pregnancy by computer aided monitoring of fetal growth
   Perinatal Institute wins 2015 BMJ Award for Clinical Leadership, for implementing national stillbirth prevention programme
   Perinatal Institute wins 2016 Queens Award for Enterprise - Innovation for reducing stillbirth rates in England