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Risk management aims to reduce poor outcomes by first identifying adverse events, creating a database to identify common patterns, and developing a system of accountability to prevent future incidents. Staffing of the labour ward may be the single most important risk. Birthrate Plus is a tool for assessing midwifery staffing that can identify shortfalls. Healthcare trusts collect a large sample of data on births related to their complexity, ranging from a simple, straightforward birth to an emergency caesarean section, and the average birth time is measured. Training may be the single most effective part of system implementation for reactive and proactive risk management. Training for staff in the core skills needed to handle emergency situations makes an important contribution to safety, although Towards Better Births found that there was a wide variation in trusts' training programmes, including the multiprofessional nature and attendance levels.
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