ObjectivesThis study aimed at describing the use of a prospective database on hospital deliveries for analysing caesarean section (CS) practices according to the WHO manual for Robson classification, and for developing recommendations for improving the quality of care (QoC).DesignObservational study.SettingUniversity Obstetric Unit at De Soysa Hospital for Women, the largest maternity unit in Sri Lanka.Data collection and analysisFor each childbirth, 150 variables were routinely collected in a standardised form and entered into a database. Data were routinely monitored for ensuring quality. Information on deliveries occurring from July 2015 to June 2017 were analysed according the WHO Robson classification manual. Findings were discussed internally to develop quality improvement recommendations.Results7504 women delivered in the hospital during the study period and at least one maternal or fetal pathological condition was reported in 2845 (37.9%). The CS rate was 30.0%, with 11.9% CS being performed prelabour. According to the Robson classification, Group 3 and Group 1 were the most represented groups (27.0% and 23.1% of population, respectively). The major contributors to the CS rate were group 5 (29.6%), group 1 (14.0%), group 2a (13.3%) and group 10 (11.5%). The most commonly reported indications for CS included abnormal cardiotocography/suspected fetal distress, past CS and failed progress of labour or failed induction. These suggested the need for further discussion on CS practices. Overall, 18 recommendations were agreed on. Besides updating protocols and hands-on training, activities agreed on included monitoring and supervision, criterion-based audits, risk management meetings and appropriate information for patients, and recommendations to further improve the quality of data.ConclusionsThis study provides an example on how the WHO manual for Robson classification can be used in an action-oriented manner for developing recommendations for improving the QoC, and the quality of data collected.

ObjectivesThis study was aimed at piloting a prospective individual patient database on hospital deliveries in Colombo, Sri Lanka, and at exploring its use for developing recommendations for improving quality of care (QoC).DesignObservational study.SettingDe Soysa Maternity Hospital, the largest referral hospital for maternity care in Sri Lanka.Data collection and analysisFrom July 2015 to June 2017, 150 variables were collected for each delivery using a standardised form and entered into a database. Data were analysed every 8 months, and the results made available to local staff. Outcomes of the study included: technical problems; data completeness; data accuracy; key database findings; and use of data.Results7504 deliveries were recorded. No technical problem was reported. Data completeness exceeded that of other existing hospital recording systems. Less than 1% data were missing for maternal variables and less than 3% for newborn variables. Mistakes in data collection and entry occurred in 0.01% and 0.09% of maternal and newborn data, respectively. Key QoC indicators identified in comparison with international standards were: relatively low maternal mortality (0.053%); relatively high maternal near-miss cases (3.4%); high rate of induction of labour (24.6%), caesarean section (30.0%) and episiotomy (56.1%); relatively high rate of preterm births (9.4%); low birthweight rate (16.5%); stillbirth (0.97%); and of total deaths in newborn (1.98%). Based on key indicators identified, a list of recommendations was developed, including the use checklists to standardise case management, training, clinical audits and more information for patients. A list of lessons learnt with the implementation of the data collection system was also drawn.ConclusionsThe study shows that the implemented system of data collection can produce a large quantity of reliable information. Most importantly, this experience provides an example on how database findings can be used for discussing hospital practices, identifying gaps and to agree on recommendations for improving QoC.

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Introduction: The erosion of many attributes of professionalism has raised concerns among medical educators which led to a mandatory module on Professionalism and Ethics being integrated into Postgraduate MD programmes in Sri Lanka. The transition of the face-to-face workshop to an online programme is one of the many ways the PGIM rose to the challenge of maintaining high-quality education while ensuring safety of trainees and faculty members during the COVID-19 pandemic. Although electronic learning is widely used, there is minimal research on its use in postgraduate medical education in developing countries such as Sri Lanka. This study aims to evaluate the response of postgraduate medical students to the transition of workshops on professionalism and ethics to an online platform. Method: A total of 148 of the 157 postgraduate students who completed the module in May 2020, participated in the study by filling the online semi-structured, self-administered questionnaire. Descriptive statistics were employed to analyze the responses to close-ended questions and the responses to open-ended questions were analyzed for recurring themes. Results: The online platform used was rated as very effective/effective by 135(91.22%) students, while 70 (47.3%) asked questions during the teaching sessions. Majority of students;141(95.27%) perceived the overall educational experience as excellent or good. Most students logged in using mobile phones, 59(39.9%) and tablet 40(27.0%), demonstrating the need to develop mobile friendly online programmes. Accessibility; a major limitation to online educational programmes in developing countries, may not be as significant as perceived to be among postgraduate medical students. Majority of students prefer a virtual mode of delivery in the future. Conclusion: The study demonstrates that students perceived the transition of the face-to-face workshop on professionalism and ethics to an online platform as a valuable educational experience. COVID-19 has adversely affected medical education all over the world. Today the classes are conducted through online platforms. Therefore, a study was conducted to evaluate the response of Sri Lankan medical postgraduate students to the transition of workshops on professionalism and ethics to an online platform.

intuition to rely on as the best course of action for hosting this event, together with our previous experience in conducting a series of webinars on COVID-19.