Access and outcomes of general practitioner obstetrician (rural generalist)‐supported birthing units in Queensland

Tennett, Debra; Kearney, Lauren

doi:10.1111/ajr.12593

Cited by 8 publications

(11 citation statements)

References 15 publications

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“…However, outside of general practice, significant gaps remain in specialist training pipelines outside of metropolitan areas 21 . In Queensland, the establishment of rural generalist training has been successful in improving access to services traditionally delivered by non‐GP specialists 22 . The broader expansion of the rural generalist model could achieve similar outcomes in other jurisdictions 23 ; however, coordination is needed to ensure structural, policy and industrial conditions support rural generalist models of training and service delivery 21 .…”

Section: Discussionmentioning

confidence: 99%

“…21 In Queensland, the establishment of rural generalist training has been successful in improving access to services traditionally delivered by non-GP specialists. 22 The broader expansion of the rural generalist model could achieve similar outcomes in other jurisdictions 23 ; however, coordination is needed to ensure structural, policy and industrial conditions support rural generalist models of training and service delivery. 21 Strengthening collaboration between training organisations in rural and remote areas could increase capacity and reduce the gaps in vocational training pathways.…”

Section: Discussionmentioning

confidence: 99%

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Surveying the changing climate of Northern Territory medical workforce retention

Pendrey

Quilty

Lucas

2022

Australian J Rural Health

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Introduction: Low retention is a significant contributor to medical workforce shortages in rural and remote regions of Australia, including in the Northern Territory (NT). Many of these areas are susceptible to climate change, which could exacerbate workforce retention problems. Objective: To examine factors influencing medical workforce retention in the NT, including the potential impact of climate change. Design: Cross sectional online survey of NT medical professionals, distributed via email through professional networks. Predominantly quantitative mixed methods (descriptive statistics, multivariate logistic regression, thematic analysis). Main 2 outcome measures reported were proportion of respondents intending to leave the NT, timeframe of intention to leave and motivating factors.Findings: Of 1407 registered practising medical professionals in the NT, 362 responded who met inclusion criteria (26% estimated response rate) and 351 completed all questions. Of the latter, 143 (41%) intended to leave the NT, 102 (29%)were unsure, and 106 (30%) did not intend to leave. Among doctors in training (DITs) 67 (55%) intended to leave and 29 (24%) were unsure. The best multivariable predictive model included only practice type (with general practitioners/ rural generalists and non-GP specialists significantly less likely to intend to leave compared to DITs), and location of primary medical degree (with non-NT training non-significantly associated with greater intention to leave). Of those intending to leave 94 (66%) reported planning to do so within two years. Training and career development opportunities, job dissatisfaction, moving to a preferred location and family-related factors were all important motivators. Of those considering leaving, 58 (24%) identified climate change as a motivating factor. Conclusion:Retention remains a key challenge in addressing rural workforce shortages. In addition to established factors, climate change is an important driver that has the potential to worsen workforce shortages in susceptible regions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surveying the changing climate of Northern Territory medical workforce retention

Pendrey

Quilty

Lucas

2022

Australian J Rural Health

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“…A recent Queensland-based study demonstrated that GPO-supported birthing units had strong indicators of quality and safety. 5 The National Rural Generalist Taskforce recognise the importance of supporting and valuing of rural generalists, including…”

Section: General Practitioner Obstetricians' Models Of Care In Rural ...mentioning

confidence: 99%

“…There has been little academic attention paid to the role of GPs or GPOs on outcomes in maternity care. A recent Queensland‐based study demonstrated that GPO‐supported birthing units had strong indicators of quality and safety 5 …”

Section: Introductionmentioning

confidence: 99%

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General practitioner obstetricians’ models of care in rural Western Australia

Wazir

Roxburgh

Moore

2022

Aust NZ J Obst Gynaeco

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Background:In Australia, a significant proportion of women live rurally and deliver their babies in services supported by general practitioner obstetricians (GPOs).While GPOs are known to be an important backbone in the provision of maternity care in Australia, little attention has been paid to their models of care. Aims:To describe the models of maternity care provided by GPOs across Western Australia. Materials and Methods:This was a multi-phase mixed-methods cross-sectional exploratory study. We invited rural GPOs in Western Australia to complete an online survey about their models of care and a sub-group of GPOs agreed to an interview to further explore their responses.Results: Thirty-five GPOs completed the survey and 12 completed an interview.We found that GPOs work in a variety of models, dependent on local community needs, resources and geography. Key attributes of GPO models are continuity of care, safety, generalism, accessibility and affordability. GPO care involves continuity of care beyond the time limits of pregnancy.Conclusions: GPOs' models of care make up an essential part of rural maternity services and have evolved to meet the needs of the communities they serve. This work informs rural generalist trainees of career pathways and policymakers about rural service provision. K E Y W O R D S rural health, maternal health services, workforce, rural generalismThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Out-of-hospital births and the experiences of emergency ambulance clinicians and birthing parents: A scoping review of the literature

Hill,

Miles,

Flanagan

et al. 2024

Preprint

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Objective Emergency ambulance services attend a wide array of medical and trauma patients. Infrequently, this includes imminent or out-of-hospital births (OOHBs). There is a paucity of research pertaining to OOHBs. This scoping review explores emergency ambulance clinician involvement with OOHBs, and patient and clinician experiences with birthing in the out-of-hospital setting. Design Scoping review; two reviewers independently determined inclusion using the Joanna Briggs Institute framework and participant, concept, context criteria. Methods CINAHL, Embase, Medline, Web of Science, and Wiley Online were searched from database inception until 20 February 2024. Articles discussing an unplanned OOHB, or a planned home birth with complications where an emergency ambulance was required were included. Results Sixty-three articles were included for review. The majority (n=36) involved retrospective research. Most articles were published since 2015 (n=38), with the highest contributing countries being USA (n=17) and Australia (n=13). Risks factors for OOHBs were varied with maternal age or being multigravida/multiparous often cited. Ninety-nine complications were described in the literature ranging from relatively minor ailments such as nausea and vomiting through to life-threatening situations such as maternal or neonatal cardiac arrest. The most common management/interventions reported were assisting with birth, maternal intravenous cannulation, and medication administration. Birth parents, partners and clinicians all describe OOHBs as anxiety-provoking but joyous when a healthy neonate is born. The OOHB experience is enhanced for patients when clinicians communicate well, while those who appeared inexperienced increased patient anxiety. OOHBs experience many challenges to optimal care, falling under the broad categories of; emergency ambulance clinicians desiring additional education and training; communication and collaboration difficulties; environmental issues; technology and aids; and other; limitations. Conclusion OOHBs are rare events requiring expert assistance to optimise patient outcomes. There remains significant challenges to unplanned OOHBs; ongoing training and skill competency is required to improve patient safety and clinician confidence.

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Access and outcomes of general practitioner obstetrician (rural generalist)‐supported birthing units in Queensland

Cited by 8 publications

References 15 publications

Surveying the changing climate of Northern Territory medical workforce retention

Surveying the changing climate of Northern Territory medical workforce retention

General practitioner obstetricians’ models of care in rural Western Australia

Out-of-hospital births and the experiences of emergency ambulance clinicians and birthing parents: A scoping review of the literature

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