In October, the AAFP's Advanced Life Support in Obstetrics (ALSO) training program celebrated its 20th year in business, having trained more than 160,000 maternity care providers worldwide in that time.
An evidence-based, multidisciplinary training program that prepares health care professionals to handle emergencies that can arise during pregnancy and childbirth, ALSO courses have been presented in 63 countries around the globe. According to family physician and ALSO Program Advisory Board Chair David Gregory, M.D., nearly 70,000 U.S. caregivers have received ALSO training, and nearly two-thirds of those caregivers have been family medicine residents.
"Obstetrics can be scary," Gregory told AAFP News Now. "ALSO makes it less scary and gets your team around you to support you. And the program has impact, not only in the United States, but throughout the world."
Gregory explained that ALSO's impact comes through the hands-on training caregivers receive during the course. Providers learn team-based approaches to mitigate situations that can pose serious harm to mother and child, including postpartum hemorrhage, shoulder dystocia and pre-eclampsia.
- The AAFP's Advanced Life Support in Obstetrics (ALSO) training program celebrated its 20th year in October.
- To date, the ALSO program has been administered in 63 countries and has trained more than 160,000 health professionals worldwide.
- Nearly 70,000 U.S. caregivers have received ALSO training, nearly two-thirds of whom have been family medicine residents.
Created in 1991 by family physician Jim Damos, M.D., the copyright to the ALSO program was purchased by the AAFP in 1993.
"This course was presented in my first year of residency -- 1994 -- and it was a revelation," Gregory said. "It demystified obstetrics for me and made it more comfortable and made me feel less anxious when it came to outcomes to which I might be exposed. It allowed me to focus my efforts on what really mattered -- the patient."
Gregory said the core attribute of the ALSO course is its evidence-based, shared mentality model.
"It's beautiful in its simplicity," he said. "Everyone knows their ABCs, so we apply them to obstetrics, using mnemonics in, for example, assisted deliveries or a shoulder dystocia.
"When in trouble, most people can remember their ABCs -- allowing all of the team members to get on the same page in their minds. From there, they can almost anticipate each other's needs and understand their own roles when it comes to those approaches."
Gregory said ALSO's evidence-based curriculum is updated on an ongoing basis.
"Our approaches have changed slightly through the years," he said. "All of those changes were, and continue to be, validated by evidence."
At this point, said Gregory, ALSO is committed to continuing to grow internationally.
"We know we've done a good job getting ALSO out there on a domestic level," he said. "But internationally, there are a lot of countries that still do not have ALSO, and (through positive outcomes from countries that have adopted the program) we know the impact and we've seen the improvements. So we need to keep rolling it out."
The program also will continue expanding the footprint of the Basic Life Support in Obstetrics (BLSO) course, which is tailored to U.S. medical and nursing students, emergency medical technicians, and other first responders. BLSO kicked off in 2012.
According to Gregory, ALSO's success to date is best measured by the outcomes experienced by those the program serves.
"It is not a milestone of years, but the number of years and patients," he said. "There's an estimate of 160,000 total providers trained in 63 countries, but it isn't the number of people trained, it's the number of mothers and babies that have been impacted by that training.
"That's 160,000 times the number of deliveries those providers have done over the last 20 years. That's something to be proud of."