9th BICCM (Bali International Combined Clinical Meeting)

Thursday (16/5/2019). Located in the Meeting Room of dr. AA Djelantik FK Unud Sudirman Denpasar, FK Unud in collaboration with Sanglah Hospital, Faculty of Medicine University of Adelaide and Woman's and Children's Hospital Adelaide held the 9th BICCM (Bali International Combined Clinical Meeting) with the theme “Interdisciplinary Collaboration Improves Quality and Safety of Care”

Unud Chancellor Prof. AA Raka Sudewi in his speech appreciated the team from Adelaide, InaCOG and POGI for their hard work and dedication for Unud and hoped that this collaboration could continue and be developed in the future in order to improve the quality of education.

In this event, the signing of an Agreement between the Indonesian College of Obstetrics and Gynecology (InaCOG) with RANZCOG and POGI as well as the Inauguration of Visiting Professors at FK Unud namely Professor John Svigos, Professor Rosalie Grivell and Professor Christopher Wilkinson from the University of Adelaide in the field of obstetrics and gynecology bridged by the Denpasar Fetomaternal Department as the leading sector of this collaboration, as well as the inauguration of several visiting lectures at the Department of Pediatrics, and the Department of Anesthesiology and Intensive Therapy (Dr. Brett Kingsley Ritchie, Dr. Nan Katherine Vasilunas, Dr. Anu Raju, Dr. Vineesh Bhatia) . Prior to the signing of the MoU with RANZCOG, in 2016 the MoU was also signed for the Medical Faculty of Udayana University – Sanglah Hospital – Adelaide University – Adelaide Women and Children Hospital . As the implementation of the signing of the MoU in 2016, there were two visits to Adelaide Women and Children Hospital led by Dr.dr.AAN Jaya Kusuma, SpOG(K) and Prof. Dr. Made Wiryana, SpAn,KIC, KAO in 2017 and 2018.

Activity review:

Bali International Combined Clinical Meeting (BICCM) is a collaboration between Adelaide and Bali which was first held by Prof. I G. Surya, the late Prof. Made Kornia and Associate Prof. John Svigos in May 2011 at Sanglah General Hospital, Bali-Indonesia. This is a three-day clinicians meeting consisting of daily plenary sessions for formal presentations along with concurrent sessions of interactive workshops and teaching. The meeting has a multidisciplinary focus aligned with contemporary fetomaternal practice and consists of obstetricians, midwives, neonatologists and obstetric anesthetists from both cities who will share their respective experiences.

The visiting faculty from Australia is dominated by experts and doctors from the Women's and Children's Hospital with input from The Lyell McEwin Hospital in Adelaide , The Royal North Shore Hospital and The Royal Prince Alfred Hospital in Sydney and The King Edward Memorial Hospital in Perth. The broader strategic aspect of this collaboration has been the rotation of three MFM trainees from Trigonum (Denpasar, Surabaya and Malang) to Adelaide for two months in 2011 and 2012 as part of their MFM training. It is hoped that the 9th BICCM will run much more successfully than the previous event.

For the ninth time, the Fetomaternal Division / SMF Obstetrics and Gynecology Faculty of Medicine, Udayana University / Sanglah General Hospital Denpasar held the Bali International Combined Clinical Meeting (BICCM). The implementation of BICCM is intended so that general practitioners and specialists always follow the development of medical science, especially in the field of Obstetrics and Gynecology in order to improve health services in the fields of promotive, preventive, curative and rehabilitative. This IX BCCM meeting carries the theme " Comprehensive Interdisciplinary Approach in Safety and Quality Improvement ". With the development of Obstetrics and Gynecology, especially in the process of pregnancy and childbirth in patients with cancer, it is increasingly becoming a challenge for us to improve services in the field of Obstetrics-Oncology to improve maternal and perinatal outcomes. Broadly speaking, the implementation will be carried out using symposium and workshop methods, then rotation visits and workshops will be held at Sanglah Hospital, Denpasar.

This agenda presents various presenters and speakers from across sectors in accordance with the big title of the agenda. The activity started on May 16, 2019 with the Inauguration to the Opening Ceremony, which was attended by the Dean of the Faculty of Medicine, Udayana University, Dr. dr. I Ketut Suyasa, SpB, SpOT (K), Chancellor of Udayana University, Prof. Dr. dr AA Raka Sudewi SpS (K), and the keynote speakers , Prof. John Svigos, Prof. Rosalie Grivell, and Prof. Chris Wilkinson. At the Opening Ceremony session, Prof Kornia Karkata's Memorial Oration was also delivered, and remarks from RANZCOG ( Royal Australian and New Zealand College of Obstetricians ). In informal sessions such as lunch, the committee arranges in such a way as to allow a warm meeting between RANZCOG and INACOG.

The second day of the BICCM, 17 May 2019, was a symposium session and scientific presentation of the BICCM agenda, where there were three parallel sessions focusing on each field: obstetrics, gynecology, anesthesia, and neonatal. In the field of obstetrics and gynecology, there were several sessions entitled: Indonesia Hospital Accreditation-quality and patient safety improvement policy in Indonesia ; Overview of Maternal Near Miss Obstetric Event and Maternal death in Bali District Hospital ; Overview of maternal mortality in South Australia and Australia; Overview of perinatal mortality in South Australia and Australia ; Antibiotics stewardship in Obstetrics Patient in Sanglah Hospital; Risk Quality and Safety in Infectious Diseases – overview +/- specific project presentation ; Evaluation of CS Rate by Robson Criteria to identified the risk of patient received for CS in Gainyar Hospital ; Risk Quality and Safety in Obstetric anaesthesia ; Short Project: Epidural anesthesia for Painless Labor in Sanglah Hospital . At other locations and venues , sessions and workshops from other collaborating departments are held simultaneously, such as: Anesthetic workshop – TB program with Anesthetic team ; and Neonatal workshop – TB program with neonatal team ; and Midwifery workshops . A series of sessions on the second day, ended with a Poster session, to the awarding of prizes to the winners of scientific posters.

The last day of the BICCM agenda took place at the Sanglah Central General Hospital (RSUP), Denpasar, Bali. Experts and keynote speakers were invited to the Weekly Obstetric Report discussion which took place at the Obgyn Meeting Room , Sanglah Hospital. After the weekly report, the invitees and speakers were directed to enjoy the morning tea session, before proceeding to the next agenda, namely, round sessions. The Adelaide Faculty Departmental Rounds will be divided into three multidisciplinary groups (approximately 10 people in each group). The invitees are invited to visit three rooms, namely: labor ward and obgyn inpatient round (delivery room and outpatient obgyn clinic); nursery ward round (baby room), and the anesthesia department. Each round lasts a maximum of 30 minutes.

In the afternoon, after the lunch session, parallel workshops and hands on training were held in several rooms. In the Clinical Training Room, Hands on Training for Residents/Registers is held, with 5 stations namely: Simpson's Forceps Delivery , Vaginal Breech Delivery . Shoulder Dystocia , Perimortem Caesarean Section , and Pudendal Block . In the JNPK Room (National Network for Clinical Training), a Midwifery Care Workshop was held. In the Fetomaternal Meeting Room, a Birth Master Class Workshop - for consultant was held, with 5 stations including: Forceps delivery , vaginal breech delivery , shoulder dystocia , perimortem caesarean section , and pudendal block . In the Department of Pediatrics, a short case presentation was held with the theme: Administration of Surfactant Using INSURE Method in Sanglah Hospital – Clinical Trial Study . After a series of events, then ended with a Closing ceremony.

The hope of the initiators and implementers of the BICCM program. through this process can provide a clear understanding and description of the potential for collaboration across disciplines, related issues and comprehensive management of the obstetrics and midwifery sector. In general, this international scale agenda is a place for discussion, presentation, and formulation of strategic solutions from experts, especially obstetrics and gynecology midwives.