Cathy Styles1, Lauren Kearney2, Kendall George3. 1. Women and Families Service Group, Sunshine Coast Hospital and Health Service, Australia. 2. Women and Families Service Group, Sunshine Coast Hospital and Health Service, Australia; School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Australia. Electronic address: Lkearney@usc.edu.au. 3. School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Australia.
Abstract
PROBLEM: Despite high quality evidence supporting midwifery continuity of care, access to this model is limited in many parts of Australia and internationally. BACKGROUND: The models of care provided to women have a strong influence on their perinatal experience and clinical outcomes. Midwifery Continuity of Care (CoC) is arguably the most significant factor in enhancing women's clinical outcomes during child-bearing and facilitating a positive childbirth experience. Health system change is required, yet little literature has detailed the actualisation of this in the context of upscaling midwifery CoC. RESEARCH QUESTION/AIM: This study aimed to explore the perceptions and experiences of midwifery and obstetric staff during the implementation and upscaling of midwifery CoC within a regional hospital and health service in coastal Queensland, Australia. METHODS: A single-site, qualitative enquiry. Obstetricians and midwives participated in semi-structured interviews or focus groups at two-time points: within 2 months of introduction of the CoC service (obstetricians n=6; midwives n=15); and 2-years after implementation (obstetricians n=5; midwives n=17). Data were analysed thematically. FINDINGS: Four key themes and several categories were generated from the data: hopes and expectations; clinical and practice changes; organisational and structural change; and, future directions. DISCUSSION: Organisational culture, structural change, communication processes and collaborative relationships can be used to inform future scale-up and sustain midwifery caseload care. Specifically, communication, inter-disciplinary collegial relationships, and managerial support are crucial to the sustainability and ultimate upscaling of caseload midwifery care. CONCLUSION: System change is challenging, but in order to improve access to midwifery CoC is necessary.
PROBLEM: Despite high quality evidence supporting midwifery continuity of care, access to this model is limited in many parts of Australia and internationally. BACKGROUND: The models of care provided to women have a strong influence on their perinatal experience and clinical outcomes. Midwifery Continuity of Care (CoC) is arguably the most significant factor in enhancing women's clinical outcomes during child-bearing and facilitating a positive childbirth experience. Health system change is required, yet little literature has detailed the actualisation of this in the context of upscaling midwifery CoC. RESEARCH QUESTION/AIM: This study aimed to explore the perceptions and experiences of midwifery and obstetric staff during the implementation and upscaling of midwifery CoC within a regional hospital and health service in coastal Queensland, Australia. METHODS: A single-site, qualitative enquiry. Obstetricians and midwives participated in semi-structured interviews or focus groups at two-time points: within 2 months of introduction of the CoC service (obstetricians n=6; midwives n=15); and 2-years after implementation (obstetricians n=5; midwives n=17). Data were analysed thematically. FINDINGS: Four key themes and several categories were generated from the data: hopes and expectations; clinical and practice changes; organisational and structural change; and, future directions. DISCUSSION: Organisational culture, structural change, communication processes and collaborative relationships can be used to inform future scale-up and sustain midwifery caseload care. Specifically, communication, inter-disciplinary collegial relationships, and managerial support are crucial to the sustainability and ultimate upscaling of caseload midwifery care. CONCLUSION: System change is challenging, but in order to improve access to midwifery CoC is necessary.
Authors: Laura Baecher-Lind; Angela C Fleming; Rashmi Bhargava; Susan M Cox; Elise N Everett; David A Forstein; Shireen Madani Sims; Helen K Morgan; Christopher M Morosky; Celeste S Royce; Tammy S Sonn; Jill M Sutton; Scott C Graziano Journal: Med Educ Online Date: 2022-12
Authors: Alyxia Gita Stellata; Fedri Ruluwedrata Rinawan; Gatot Nyarumenteng Adhipurnawan Winarno; Ari Indra Susanti; Wanda Gusdya Purnama Journal: Int J Environ Res Public Health Date: 2022-08-28 Impact factor: 4.614