Improving systems of care during and after a pregnancy complicated by hyperglycaemia: A protocol for a complex health systems intervention

Abstract

Background: Many women with hyperglycaemia in pregnancy do not receive care during and after pregnancy according to standards recommended in international guidelines. The burden of hyperglycaemia in pregnancy falls disproportionately upon Indigenous peoples worldwide, including Aboriginal and Torres Strait Islander women in Australia. The remote and regional Australian context poses additional barriers to delivering healthcare, including high staff turnover and a socially disadvantaged population with a high prevalence of diabetes.

Improving systems of prenatal and postpartum care for hyperglycemia in pregnancy: A process evaluation

“…Methods for this health systems intervention have been described in detail previously 23 . Five key components were identified through health professional focus groups in 2016–2017: Increasing workforce capacity, skills, and knowledge, and improving the health literacy of clinicians and women. Improving access to health care through culturally and clinically appropriate pathways. Improving information management and communication. Enhancing policies and guidelines. Embedding a clinical register for women with hyperglycemia in pregnancy 24 within the models of care. …”

“…Logic model for a health systems intervention to improve care for women during and after a pregnancy complicated by diabetes (licensed under CC BY 4.0 by D. MacKay et al 23 )…”

“…Methods for this health systems intervention have been described in detail previously. 23 Five key components were identified through health professional focus groups in 2016-2017:…”

Perspectives: Envisioning healthcare quality and safety in 2030

“…medication reconciliation) (Russ et al., 2020), and reduction of unwarranted variations in patient outcomes (e.g. diabetes management) (MacKay et al., 2020). As such, improvement science has emphasised measurement, feedback to decision-makers, and organisational change all in order to address a well-defined clinical problem or quality gap.…”

Early Detection of Type 2 Diabetes among Women with Previous Gestational Diabetes Mellitus: Development and Pilottest of an Intervention to Aid Women's Decision on Participation in Follow-Up Screening

“…An increasing number of studies from especially Australia have started to address the problem of undiagnosed T2DM after GDM on a health system level (139,140). This offers important perspectives that can be combined with the more individual and service-level approach applied in this PhD study.…”