Labouring Together: collaborative alliances in maternity care in Victoria, Australia—protocol of a mixed-methods study

Abstract

IntroductionFor over a decade, enquiries into adverse perinatal outcomes have led to reports that poor collaboration has been detrimental to the safety and experience of maternity care. Despite efforts to improve collaboration, investigations into maternity care at Morecambe Bay (UK) and Djerriwarrh Health Services (Australia) have revealed that poor collaboration and decision-making remain a threat to perinatal safety. The Labouring Together study will investigate how elements hypothesised to influence the effectiveness of collaboration are reflected in perceptions and experiences of clinicians and childbearing women in Victoria, Australia. The study will explore conditions that assist clinicians and women to work collaboratively to support positive maternity outcomes. Results of the study will provide a platform for consumers, clinician groups, organisations and policymakers to work together to improve the quality, safety and experience of maternity care.Methods and analysis4 case study sites have been selected to represent a range of models of maternity care in metropolitan and regional Victoria, Australia. A mixed-methods approach including cross-sectional surveys and interviews will be used in each case study site, involving both clinicians and consumers. Quantitative data analysis will include descriptive statistics, 2-way multivariate analysis of variance for the dependent and independent variables, and χ2 analysis to identify the degree of congruence between consumer preferences and experiences. Interview data will be analysed for emerging themes and concepts. Data will then be analysed for convergent lines of enquiry supported by triangulation of data to draw conclusions.Ethics and disseminationOrganisational ethics approval has been received from the case study sites and Deakin University Human Research Ethics Committee (2014–238). Dissemination of the results of the Labouring Together study will be via peer-reviewed publications and conference presentations, and in written reports for each case study site to support organisational change.

The use of the PARIHS framework in implementation research and practice—a citation analysis of the literature

“…Of the articles reporting type of setting where the implementation project/research took place, a majority were undertaken in hospitals ( n = 126) [ 26 , 27 , 30 , 38 , 39 , 41 , 42 , 45 , 49 , 51 – 55 , 60 , 62 – 64 , 67 , 70 – 72 , 77 , 84 , 85 , 88 , 89 , 95 – 98 , 103 , 106 , 107 , 111 , 115 – 118 , 120 – 122 , 128 , 131 , 132 , 136 , 137 , 139 , 143 , 146 , 149 , 151 , 153 – 155 , 157 , 161 , 165 , 167 – 169 , 172 , 173 , 175 , 180 – 182 , 184 , 186 , 190 – 193 , 205 , 207 , 212 , 215 , 221 , 223 , 227 , 230 , 231 ,…”

“…There were 184 (50%) articles where the PARIHS framework was reported to be used in the analysis [ 2 , 13 , 23 – 35 , 47 – 55 , 58 – 82 , 84 – 94 , 149 – 242 , 313 , 314 , 316 – 322 , 339 , 341 – 358 , 386 , 389 ]. Most of these involved empirical studies ( n = 131) [ 58 – 82 , 84 – 94 , 149 – 242 , 386 ] where PARIHS often was described as guiding or framing the data collection, e.g., developing an interview guide, and/or analysis, but with no further details.…”

“…In these articles, the analysis was performed in different ways, primarily through mapping and comparing PARIHS to other frameworks or models or even policies, but also for general discussions on implementation and evidence-based practice. Among the 185 articles that reported using the PARIHS framework in the analysis, there were also 22 protocols where authors reported that the intention was to use the framework in the analysis [23][24][25][26][27][28][29][30][31][32][33][34][35][47][48][49][50][51][52][53][54][55].…”

Labouring Together: Women's experiences of “Getting the care that I want and need” in maternity care

“…The Labouring Together study was conducted to explore these issues further. Study aims were to investigate: (a) perceptions of collaborative maternity care held by maternity care professionals and women from a variety of maternity care models available in Victoria, Australia; (b) how the essential elements hypothesised to influence the effectiveness of collaborative alliances are reflected in perceptions of collaboration in maternity care in Victoria; and (c) childbearing women's' preferences for and experiences of collaboration and control over decision-making in maternity care (Watkins, Nagle, Kent, & Hutchinson, 2017).…”

Integrated Maternal Care Strategies in Low- and Middle-Income Countries: A Systematic Review

“…This means that the tasks that are part of the process of care must be departmentalised and assigned so that they can be performed in a way that successfully produces the desired result [3]. However, often women perceive maternal care to be disjointed, uncoordinated, and incoherent, particularly in low-and middle-income countries [4][5][6][7][8].…”