Jocelyn Toohill1, Yogesh Chadha2, Shelley Nowlan3. 1. Adjunct Professor, Director of Midwifery, Office of the Chief Nursing and Midwifery Officer, Clinical Excellence Division, Department of Health, Queensland, Australia, SONM Griffith University and Transforming Maternity Care Collaborative. 2. Obstetrician/Gynaecologist, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Queensland Health and Snr Lecturer School of Medicine University of Queensland. 3. Chief Nursing and Midwifery Officer, Office of the Chief Nursing and Midwifery Officer, Clinical Excellence Division, Department of Health, Queensland, Australia, Adjunct Professor SONM University of Queensland and School of Medicine Griffith University.
Abstract
BACKGROUND: Low numbers of women in Queensland receive continuity of care across their maternity episode. The Office of the Chief Nursing and Midwifery Officer was tasked with strengthening maternity service delivery by reviewing and improving Maternity Models of Care and Workforce. AIM: Develop a decision-making framework (DMF) to increase maternity continuity of carer models. METHOD: A literature review of models, specific to the public health maternity system, including suitability to rural areas and culturally appropriate to Aboriginal and Torres Strait Islander women was undertaken. Stakeholders informed development of the framework and toolkit. A prototype was built, tested and refined following input from rural, regional and metropolitan facilities. RESULTS: 42 questions guide services to contextualise delivery of continuity of carer to local circumstances. Three rural sites have applied the i-DMF and toolkit. One used the tool for quality assurance of their existing midwifery continuity model, another has developed a midwifery continuity-of-carer model for Aboriginal and Torres Strait Islander women, the other is looking to establish a local rural birth service. CONCLUSION: The i-DMF has potential to grow and sustain best practice maternity care, and particularly enable more women to receive relationship-based care with a known midwife.
BACKGROUND: Low numbers of women in Queensland receive continuity of care across their maternity episode. The Office of the Chief Nursing and Midwifery Officer was tasked with strengthening maternity service delivery by reviewing and improving Maternity Models of Care and Workforce. AIM: Develop a decision-making framework (DMF) to increase maternity continuity of carer models. METHOD: A literature review of models, specific to the public health maternity system, including suitability to rural areas and culturally appropriate to Aboriginal and Torres Strait Islander women was undertaken. Stakeholders informed development of the framework and toolkit. A prototype was built, tested and refined following input from rural, regional and metropolitan facilities. RESULTS: 42 questions guide services to contextualise delivery of continuity of carer to local circumstances. Three rural sites have applied the i-DMF and toolkit. One used the tool for quality assurance of their existing midwifery continuity model, another has developed a midwifery continuity-of-carer model for Aboriginal and Torres Strait Islander women, the other is looking to establish a local rural birth service. CONCLUSION: The i-DMF has potential to grow and sustain best practice maternity care, and particularly enable more women to receive relationship-based care with a known midwife.
Authors: H L McLachlan; D A Forster; M A Davey; T Farrell; L Gold; M A Biro; L Albers; M Flood; J Oats; U Waldenström Journal: BJOG Date: 2012-07-25 Impact factor: 6.531