Collaboration in <scp>M</scp>aternity <scp>C</scp>are is achievable and practical

Beasley, Sarah; Ford, Naomi; Tracy, Sally; Welsh, Alec

doi:10.1111/ajo.12003

Cited by 16 publications

(11 citation statements)

References 20 publications

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“…29 It reduces duplication and fragmentation of care that may result in miscommunication and inadequate medical record keeping, both of which are associated with poor outcomes including maternal deaths. 39 This may be one reason women allocated to caseload care perceived their antenatal care was performed competently and was rated more highly overall than fragmented care. 39 This may be one reason women allocated to caseload care perceived their antenatal care was performed competently and was rated more highly overall than fragmented care.…”

Section: Discussionmentioning

confidence: 99%

“…38 Caseload midwifery is a clinical risk management strategy in that it fosters informational and management continuity through the care practitioner knowing the woman and her history. 39 This may be one reason women allocated to caseload care perceived their antenatal care was performed competently and was rated more highly overall than fragmented care.…”

Section: Discussionmentioning

confidence: 99%

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The impact of caseload midwifery, compared with standard care, on women's perceptions of antenatal care quality: Survey results from the M@NGO randomized controlled trial for women of any risk

Allen

Kildea

Tracy

et al. 2019

Birth

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Background:The measurement and interpretation of patient experience is a distinct dimension of health care quality. The Midwives @ New Group practice Options (M@NGO) randomized control trial of caseload midwifery compared with standard care among women regardless of risk reported both clinical and cost benefits. This study reports participants' perceptions of the quality of antenatal care within caseload midwifery, compared with standard care for women of any risk within that trial. Methods: A trial conducted at two Australian tertiary hospitals randomly assigned participants (1:1) to caseload midwifery or standard care regardless of risk. Women were sent an 89-question survey at 6 weeks postpartum that included 12 questions relating to pregnancy care. Ten survey questions (including 7-point Likert scales) were analyzed by intention to treat and illustrated by participant quotes from twofree-text open-response items. Results: From the 1748 women recruited to the trial, 58% (n = 1017) completed the 6-week survey. Of those allocated to caseload midwifery, 66% (n = 573) responded, compared with 51% (n = 444) of those allocated to standard care. The survey found women allocated to caseload midwifery perceived a higher level of quality care across every antenatal measure. Notably, those women with identified risk factors reported higher levels of emotional support (aOR 2.52 [95% CI 1.87-3.39]), quality care (2.94 [2.28-3.79]), and feeling actively involved in decision-making (3.21 [2.35-4.37]). Conclusions: Results from the study show that in addition to the benefits to clinical care and cost demonstrated in the M@NGO trial, caseload midwifery outperforms standard care in perceived quality of pregnancy care regardless of risk. K E Y W O R D S antenatal care, midwifery, randomized controlled trial, survey 440 | ALLEN Et AL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impact of caseload midwifery, compared with standard care, on women's perceptions of antenatal care quality: Survey results from the M@NGO randomized controlled trial for women of any risk

Allen

Kildea

Tracy

et al. 2019

Birth

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“…A lack of medical staff support continues to be cited as an obstacle to change in many services 51 . Nevertheless, some services have been developed through effective and respectful collaboration between midwives and doctors, and there is evidence that such interprofessional collaboration is attainable in midwifery continuity of care models 52 …”

Section: Translating This Evidence Into Practicementioning

confidence: 99%

“…51 Nevertheless, some services have been developed through effective and respectful collaboration between midwives and doctors, and there is evidence that such interprofessional collaboration is attainable in midwifery continuity of care models. 52 Recruiting and retaining midwives who are interested in and available for work in this model remain problems for many services. However, all new graduates from Australian midwifery programs have had opportunities to work in this way during their education, 53 and many want to work this way in the future.…”

Section: Midwifery Continuity Of Care: Effect On Organisations and MImentioning

confidence: 99%

Models of maternity care: evidence for midwifery continuity of care

Homer

2016

Medical Journal of Australia

157

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There has been substantial reform in the past decade in the provision of maternal and child health services, and specifically regarding models of maternity care. Increasingly, midwives are working together in small groups to provide midwife-led continuity of care. This article reviews the current evidence for models of maternity care that provide midwifery continuity of care, in terms of their impact on clinical outcomes, the views of midwives and childbearing women, and health service costs. A systematic review of midwife-led continuity of care models identified benefits for women and babies, with no adverse effects. Non-randomised studies have shown benefits of midwifery continuity of care for specific groups, such as Aboriginal and Torres Strait Islander women. There are also benefits for midwives, including high levels of job satisfaction and less occupational burnout. Implementing midwifery continuity of care in public and private settings in Australia has been challenging, despite the evidence in its favour and government policy documents that support it. A reorganisation of the way maternity services are provided in Australia is required to ensure that women across the country can access this model of care. Critical to such reform is collaboration with obstetricians, general practitioners, paediatricians and other medical professionals involved in the care of pregnant women, as well as professional respect for the central role of midwives in the provision of maternity care. More research is needed into ways to ensure that all childbearing women can access midwifery continuity of care.

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“…Collaborative models of care and good working relationships between staff can lessen the feeling of inadequacy and enhance safe practice. There has, however, been less focus on emotional safety of staff working in collaboration with other health professionals, and this needs attention to assist with staff retention and well‐being (Beasley, Ford, Tracy, & Welsh, ; Leap, Dahlen, Brodie, Tracy, & Thorpe, ). Many obstetric emergency training programmes such as Practical Obstetric Multi‐Profession Training (PROMPT) and Advanced Life Support in obstetrics (ALSO) emphasise team work and working collaboratively in adverse outcome situations.…”

Section: Implications For Midwifery and Nursing Practicementioning

confidence: 99%