The NSW Fetal welfare assessment, Obstetric emergencies and Neonatal resuscitation Training © (FONT), a mandated education requirement for all NSW Health maternity clinicians, underwent a major review in 2019.
The NSW FONT education program was developed in 2008, as a risk management strategy in response to several adverse events in maternity care. The objective of the FONT education program was to improve the safety of maternity care by facilitating and promoting a collaborative approach to assessing, detecting, managing and escalating clinical deterioration in maternal, fetal and newborn conditions.
The FONT program has been renamed Perinatal Safety Education and has been redesigned with significant changes to the program and the delivery of training.
Perinatal Safety Education
The new Perinatal Safety Education pathway will replace FONT training with a focus on improving the recognition, response to, and management of the deteriorating fetus and the deteriorating woman. Perinatal Safety Education aligns with the updated Deteriorating Patient Education program and ensures that perinatal safety remains an integral part of the Deteriorating Patient Education program for maternity clinicians.
Within Perinatal Safety Education there are dual pathways of Fetal Safety Education and Maternal Safety Education. The Perinatal Safety Education program features the critical importance of individual risk factor recognition that must underpin clinical decision making for mothers and babies. This focus enables clinicians to view the 'whole picture’ in assessments, thereby improving situational awareness.
Human factors, the scientific discipline concerned with the understanding of interactions among humans, has been introduced into this education to increase knowledge and awareness amongst clinicians and provide strategies to potentially reduce human error in clinical practice. Using Human Factors principles can enhance patient safety and clinical quality, while a failure to apply Human Factors principles is frequently an aspect of adverse events in health care.
The program has been approved by the NSW Mandatory Training Standards Committee and remains mandatory education for maternity clinicians. The learning pathway includes online components with annual face to face training and knowledge assessment which has an overall reduction in education hours.
The new learning pathways include:
Online modules (which will replace K2) for both Maternal and Fetal Education, to be completed only once.
An annual online assessment quiz for both Fetal and Maternal Safety Education. This must be completed successfully to achieve compliance.
3 hours of Fetal Safety and 3 hours of Maternal Safety face to face educational content (team training) to be completed annually.
Governance arrangements for the redesign
The Ministry of Health is leading the FONT redesign process, in collaboration with the Clinical Excellence Commission (CEC) and the Health Education and Training Institute (HETI). The process is supported by:
· The FONT Redesign Steering Group, Co-Chaired by Carrie Marr, Chief Executive, CEC and Tish Bruce, Executive Director, Health and Social Policy Branch, Ministry of Health. The Group meets quarterly and provides oversight of the project process.
· The FONT Clinical Advisory group, Chaired by Clinical Professor Michael Nicholl, Senior Clinical Advisor, Obstetrics. The group meets every two months and advises on the new Patient Safety education. This group reports to the FONT Redesign Steering Group.
The groups include maternity clinicians and managers, representing both metro and rural districts.
Perinatal Safety Education Implementation -Next steps
A phased launch is planned during 2020/21 to maximise clinical safety and minimise disruption to clinical education planning.
Fetal Safety Education: The new online modules were launched on My Health Learning in April 2020, followed by new face to face content facilitated by instructors from 1 May 2020. A final Antenatal module will be launched in August 2020.
Maternal Safety Education: After a period of instructor preparation the new online modules and face to face content will be launched – this is anticipated for February 2021. Until that time, targeted staff will continue with the current Obstetric emergency and Neonatal resuscitation training (ONT) and K2 Maternal crisis modules until the new pathway is released.
Fetal Safety Education Week (17-20 August 2020) will focus on Fetal Safety Education and increase awareness of the new Perinatal Safety Education program overall. Many virtual events will be held during this week that will promote the new program materials to maternity care providers such as webinars, open forums and the release of new face to face resources.
Support for Educators
The Clinical Excellence Commission (CEC) facilitates a Community of Practice for current FONT instructors through regular virtual forums using Skype for Business. This provides a dedicated virtual space for resources and facilitates virtual discussions between members.
Regular communication regarding the progress of the FONT redesign project is communicated via newsletters to chief executives for distribution. Additional information will be emailed to the designated FONT district maternity leads.
For more details: