Management and sustainability of midwifery group practice: Thematic and lexical analyses of midwife interviews

Hewitt, Leonie; Hartz, Donna; Dahlen, Hannah G

doi:10.1016/j.wombi.2021.05.002

Cited by 4 publications

(6 citation statements)

References 25 publications

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“…The schedule of questions encompassed what the participants saw were necessary characteristics for the MGP manager role, (see Table 2). The questions were built from previous studies looking at the role of the MGP manager [23,24]. Information that could identify the individuals who participated was changed to protect their anonymity and pseudonyms were used.…”

Section: Methodsmentioning

confidence: 99%

“…A previous study described the ability to form relationships, as crucial to MGP management [34]. Forming strong interdisciplinary relationships with stakeholders, other departmental managers, hospital staff, and the MGP midwives is essential to the MGP managers' role [24,34]. Relational leadership and management, as opposed to hierarchical styles, can promote sustainability by encouraging harmony within and outside the practice [35].…”

Section: Mirroring Good Midwifery Carementioning

confidence: 99%

“…Self-care practices might not only save and sustain the manager; it might be something the manager can encourage within the MGP, which also helps to sustain the MGP. In a study on MGP midwives views regarding MGP management and sustainability, the midwives described the importance of self-care and of the manager supporting these practices [24]. While the health care facility might focus on budgetary requirements and accountability to the hierarchy rather than the consumers, the microcosm of the MGP could be a starting point for cultural change.…”

Section: The Role Of Self-carementioning

confidence: 99%

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Midwife-centred management: a qualitative study of midwifery group practice management and leadership in Australia

Hewitt

Hartz

Dahlen

2022

BMC Health Serv Res

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Background Midwifery group practice (MGP) has consistently demonstrated optimal health and wellbeing outcomes for childbearing women and their babies. In this model, women can form a relationship with a known midwife, improving both maternal and midwife satisfaction. Yet the model is not widely implemented and sustained, resulting in limited opportunities for women to access it. Little attention has been paid to how MGP is managed and led and how this impacts the sustainability of the model. This study clarifies what constitutes optimal management and leadership and how this influences sustainability. Methods This qualitative study forms part of a larger mixed methods study investigating the management of MGP in Australia. The interview findings presented in this study are part of phase one, where the findings informed a national survey. Nine interviews and one focus group were conducted with 23 MGP managers, clinical midwife consultants, and operational/strategic managers who led MGPs. Transcripts of the audio-recordings were analysed using inductive, reflexive, thematic analysis. Results Three themes were constructed, namely: The manager, the person, describing the ideal personal attributes of the MGP manager; midwifing the midwives, illustrating how the MGP manager supports, manages, and leads the group practice midwives; and gaining acceptance, explaining how the MGP manager can gain acceptance beyond group practice midwives. Participants described the need for MGP managers to display midwife-centred management. This requires the manager to have qualities that mirror what is generally accepted as requirements for good midwifery care namely: core beliefs in feminist values and woman-centred care; trust; inclusiveness; being an advocate; an ability to slow down or take time; an ability to form relationships; and exceptional communication skills. Since emotional labour is a large part of the role, it is also necessary for them to encourage and practice self-care. Conclusions Managers need to practice in a way that is midwife-centred and mimics good midwifery care. To offset the emotional burden and improve sustainability, encouraging and promoting self-care practices might be of value.

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Section: Methodsmentioning

confidence: 99%

Section: Mirroring Good Midwifery Carementioning

confidence: 99%

Section: The Role Of Self-carementioning

confidence: 99%

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Midwife-centred management: a qualitative study of midwifery group practice management and leadership in Australia

Hewitt

Hartz

Dahlen

2022

BMC Health Serv Res

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“…Part-time working midwives in the metropolitan setting also expressed that caseload size impacted their ability to complete all tasks 31 . Similarly, midwives interviewed in the qualitative study found caseload size one of the most significant challenges in the MCoC model, with the parttime worker expressing that they could only cope with the workload because they worked part-time 37 .…”

Section: Workload Challenges Ideal Part-time Hours (Fte)mentioning

confidence: 96%

“…This study gives critical evidence to factors contributing to the recruitment and retention of midwives entering the workforce. The qualitative study that interviewed 8 MGP midwives across Australia investigated the factors they perceive to contribute to the sustainability of MCoC models 37 . Midwives in this study came from different work environments and states and territories.…”

Section: Study Characteristicsmentioning

confidence: 99%

The role of part-time arrangements in the sustainability of midwifery continuity of care models in Australia: An integrative review

Aleshin,

Donnellan-Fernandez

2023

Eur J Midwifery

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INTRODUCTION International maternity care experts have called for expanding midwiferyled continuity of care (MCoC) models. However, the number of models need augmentation as the number of women receiving this care is small. The majority of the midwifery workforce in Australian public health systems comprises women who work part-time. This aspect of the midwifery workforce demands careful consideration when attempting to change a maternity care system and sustain new models of care. Sparse research has been undertaken to explore whether part-time factors could play a role in the growth and sustainability of MCoC in Australia. This integrative review aims to analyze the role of parttime practice arrangements in the sustainability of MCoC models in Australia. METHODS Following a systematic search of research databases (CINAHL, ScienceDirect, Cochrane Database of Systematic Reviews, and Proquest) and screening the literature with eligibility criteria including keywords related to midwifery continuity of care, workforce arrangements and full-time equivalent (FTE), eight Australian research articles were identified for evaluation. The articles were appraised for bias using the Mixed Methods Appraisal Tool (MMAT) and data were analyzed using an integrated convergent narrative synthesis method. RESULTS The resulting themes from the synthesis suggest that part-time MCoC roles may support the sustainability of the MCoC workforce without reducing quality of care to women. In various studies, midwives reported that FTE (full-time equivalent) of 0.5 may not meet the job's demands. However, this is likely influenced by local context and caseload size rather than the quantum of each midwife's FTE. The quality of the studies is limited due to the small scale of the studies; however, the qualitative results give a depth of understanding to the strengths and challenges that part-time arrangements in MCoC add to the midwifery workforce. CONCLUSIONS This review recommends that part-time arrangements in MCoC models in Australia be evaluated in conjunction with other routinely analyzed workforce data. Further considerations should be made by midwifery managers, leaders, stakeholders, and decision makers responsible for developing and supporting part-time job arrangements in caseload models of care in Australia.

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Midwifery group practice workforce in Australia: A cross-sectional survey of midwives and managers

Hewitt,

Dadich,

Hartz

et al. 2024

Women and Birth

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Management and sustainability of midwifery group practice: Thematic and lexical analyses of midwife interviews

Cited by 4 publications

References 25 publications

Midwife-centred management: a qualitative study of midwifery group practice management and leadership in Australia

Midwife-centred management: a qualitative study of midwifery group practice management and leadership in Australia

The role of part-time arrangements in the sustainability of midwifery continuity of care models in Australia: An integrative review

Midwifery group practice workforce in Australia: A cross-sectional survey of midwives and managers

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