On May 1, 2024, BORN launched the largest single implementation of perinatal improvements to the BORN Information System (BIS) to date. This significant update was the result of collaborative efforts by the entire BORN team as well as data contributors, partners, and working group members.

How Were Enhancements Selected?

• Recommendations from BIS data partners
• Guidance from clinical advisory groups
• Alignment with emerging best practice literature and new practice guidelines
• Insights from a prioritization matrix

What are the Expected Benefits?

• Improved data accuracy
• Reduced barriers for data submission
• Ability to leverage data effectively to improve care and outcomes for pregnant and birthing families in Ontario

What were the Major Changes?

• Standardized definitions of induction and augmentation of labour were implemented
• A standardized definition for the onset of active labour was implemented and will be used as the benchmark for labour onset
• Type of birth options were simplified 
• Data elements were added to support a new screening program involving Fetal Blood Group Genotyping (FBGG) and the administration of Rhogam

Why was it Important to Standardize the Definitions?

Standardizing the definitions of stages and phases of labour in the BIS was crucial for several reasons:

1. Consistency in Data Collection: Standard definitions ensure that data on labour stages and phases is recorded consistently across different healthcare providers and institutions. This minimizes discrepancies and variations, making the data more reliable.
2. Improved Comparability: When data definitions are uniform, comparisons across time periods, institutions, and regions become valid. This is essential for tracking trends, evaluating interventions, and comparing outcomes in maternal and newborn health.
3. Enhanced Clinical Decision-Making: Clear and consistent definitions aid healthcare providers in making evidence-based clinical decisions, such as when to initiate interventions (e.g., oxytocin administration) based on specific phases of labour. This alignment with standardized guidelines like the Provincial Council for Maternal and Child Health’s (PCMCH) supports safer labour management.
4. Better Quality Improvement (QI): In QI initiatives, standardized definitions are necessary to identify where improvements are needed, measure changes effectively, and demonstrate improvements in labour and birth outcomes. This is especially relevant in the context of safe labour induction and augmentation protocols.
5. Regulatory and Benchmarking Purposes: Standardized definitions are essential for meeting regulatory requirements and benchmarking. They allow our system to align with regional or national standards, such as those in Ontario or across Canada, improving the utility of BORN data for broader health system evaluations.

By establishing these standards, the system gains a solid foundation for monitoring and improving maternal and neonatal outcomes.

Resources Provided to Support Organizations and Practice Groups

• Comprehensive Guide (including a clinical rationale for every data element change)
• One-page Overview
• Type of Labour Decision Tree Tool
• Clinical Scenarios Q & A
• Webinar Recording
• Customizable Slide Deck for adaptation and use within organizations and practice groups
• Infographics (to help with documenting the more complicated data elements)
• Updated BORN Information System Downtime Forms