Aim The postnatal ward is the largest in the region with rapid turnover of patients. Daily workload includes review of neonates and examination of the newborn (EON) within 72 hours of birth (national standard). Problems include: conflict on which neonates require EON to be carried out by paediatrician, multiple lists detailing which neonates require EON and lack of relevant information on review list needed to ensure prioritisation of workload.

Method We liased with midwives, ward manager and trainees to discuss current workload. We met with the Clinical Director to discuss concerns raised and to clarify guidelines for in-hospital vs community midwife EON. We created a questionnaire, made changes in-line with staff concerns and repeated the questionnaire post-intervention. The Paediatric trainee was moved from a mobile work station to a permanent room with a computer, printer and dedicated referral forms. A proforma was created including all the information required for EON, to be filled out by the parent prior to examination. A new proforma was created for reviews. The Clinical Director agreed to help create a new guideline on criteria for an in-hospital vs community midwife EON.

Conclusion Our intervention undoubtedly leads to a more efficient service and means more babies can be examined in a given time. The service also benefits from being carried out in a private space, increasing confidentiality. Furthermore, reaching agreed criteria for in-hospital vs community midwife EON could potentially further improve discharge times.