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Reductions in late gestation stillbirth rates have steadily improved in Australia. However, to amplify and sustain reductions, more needs to be done to reduce practice variation and address sub-optimal care. Implementing bundles for maternity care improvement in the UK have been associated with a 20% reduction in stillbirth rates. A similar approach is underway in Australia; the Safer Baby Bundle (SBB) with five elements: 1) supporting women to stop smoking in pregnancy, 2) improving detection and management of fetal growth restriction, 3) raising awareness and improving care for women with decreased fetal movements, 4) improving awareness of maternal safe going-to-sleep position in late pregnancy, 5) improving decision making about the timing of birth for women with risk factors for stillbirth.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This is a mixed-methods study of maternity services across three Australian states; Queensland, Victoria and New South Wales. The study includes evaluation of \u2018targeted\u2019 implementer sites (combined total approximately 113,000 births annually, 50% of births in these states) and monitoring of key outcomes state-wide across all maternity services. Progressive implementation over 2.5 years, managed by state Departments of Health, commenced from mid-2019. This study will determine the impact of implementing the SBB on maternity services and perinatal outcomes, specifically for reducing late gestation stillbirth. Comprehensive process, impact, and outcome evaluations will be conducted using routinely collected perinatal data, pre- and post- implementation surveys, clinical audits, focus group discussions and interviews. Evaluations explore the views and experiences of clinicians embedding the SBB into routine practice as well as women\u2019s experience with care and the acceptability of the initiative.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Discussion<\/jats:title>\n<jats:p>This protocol describes the evaluation of the SBB initiative and will provide evidence for the value of a systematic, but pragmatic, approach to strategies to reduce the evidence-practice gaps across maternity services. We hypothesise successful implementation and uptake across three Australian states (amplified nationally) will be effective in reducing late gestation stillbirths to that of the best performing countries globally, equating to at least 150 lives saved annually.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Trial registration<\/jats:title>\n<jats:p>The Safer Baby Bundle Study was retrospectively registered on the <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?id=378768\">ACTRN12619001777189<\/jats:ext-link> database, date assigned 16\/12\/2019<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12884-020-03401-0","type":"journal-article","created":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T17:02:47Z","timestamp":1605286967000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Implementation and evaluation of a quality improvement initiative to reduce late gestation stillbirths in Australia: Safer Baby Bundle study protocol"],"prefix":"10.1186","volume":"20","author":[{"name":"on behalf of the Safer Baby Bundle collaborators","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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The processes used by this HREC to review multi-centre research proposals have been certified by the National Health and Medical Research Council. The waiver of consent and breach of the Australian Privacy Principles for the collection of retrospective health data were considered justified in accordance with National Statement 2.3.10 and are approved. Obtaining consent from participants for survey components is built into electronic surveys, on the introductory page participants are informed that \u2018by completing and submitting this survey, you will be indicating your consent to participate\u2019. Written consent will be obtained from participants prior to undertaking in-person interviews and focus groups. Due to limitations with undertaking in-person interviews\/focus groups as a result of COVID-19 restrictions, ethics approval was also obtained to attain informed consent either verbally (for phone interviews) or electronically (prior to on-line focus groups through consent question in an on-line registration portal).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"VF is Co-Director for the Stillbirth CRE and receives salary support through an NHMRC Career Development Fellowship. DE is Co-Director of the Stillbirth CRE and has received funding from NHMRC and MRFF. PM is a chief investigator on the Stillbirth CRE and receives salary support through a NHMRC Investigator Grant. All other authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"694"}}