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The OASI care bundle quality improvement project: lessons learned and future direction

Research output: Contribution to journalArticlepeer-review

Magdalena Jurczuk, Posy Bidwell, Ipek Gurol-Urganci, Jan van der Meulen, Nick Sevdalis, Louise Silverton, Ranee Thakar

Original languageEnglish
Pages (from-to)1989-1995
Number of pages7
JournalInternational Urogynecology Journal
Issue number7
Accepted/In press2021
PublishedJul 2021

Bibliographical note

Funding Information: Evaluation of the OASI-CB was funded by the Health Foundation. The research of N.S. is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South London at King’s College Hospital NHS Foundation Trust. N.S. is a member of King’s Improvement Science, which offers co-funding to the NIHR ARC South London and is funded by King’s Health Partners (Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, King’s College London and South London and Maudsley NHS Foundation Trust), and Guy’s and St Thomas’ Charity. The views expressed in this publication are those of the authors and not necessarily those of the Health Foundation, NIHR, or the Department of Health and Social Care. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Rising rates of obstetric anal sphincter injury (OASI) led to a collaborative effort by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) to develop and evaluate the OASI Care Bundle (OASI-CB). The OASI-CB comprises four practices (antenatal discussion about OASI, manual perineal protection, mediolateral episiotomy at 60° from the midline, and systematic examination of the perineum, vagina and ano-rectum after vaginal birth) and was initially implemented as part of a quality improvement (QI) project—“OASI1”—in 16 maternity units across Great Britain. Evaluation of the OASI1 project found that the care bundle reduced OASI rates and identified several barriers and enablers to implementation. This paper summarises the key findings, including strengths, limitations and lessons learned from the OASI1 QI project, and provides rationale for further evaluation of the OASI-CB.

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