Transitioning across professional boundaries in midwifery models of care: A literature review

Baldwin, Adele; Harvey, Clare; Willis, Eileen; Ferguson, Bridget; Capper, Tanya

doi:10.1016/j.wombi.2018.08.003

Cited by 18 publications

(12 citation statements)

References 29 publications

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“…Communication, and interpersonal/relational dimensions in particular, have also been identified as one of four dimensions in midwifery models of care. In obstetrics, the biomedical or pathogenic approach to patient care adopted by physicians may clash with nurses’ or midwives’ salutogenetic approaches [31]. These models consider that – unlike most other reasons to visit a hospital – birth is a natural process in most cases and a joyful moment for the parents, but it can also cause uncertainty or fear.…”

Section: Introductionmentioning

confidence: 99%

Communication and patient safety in gynecology and obstetrics - study protocol of an intervention study

Lippke

Wienert

Keller

et al. 2019

BMC Health Serv Res

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Background: Patient safety is a key target in public health, health services and medicine. Communication between all parties involved in gynecology and obstetrics (clinical staff/professionals, expectant mothers/patients and their partners, close relatives or friends providing social support) should be improved to ensure patient safety, including the avoidance of preventable adverse events (pAEs). Therefore, interventions including an app will be developed in this project through a participatory approach integrating two theoretical models. The interventions will be designed to support participants in their communication with each other and to overcome difficulties in everyday hospital life. The aim is to foster effective communication in order to reduce the frequency of pAEs. If communication is improved, clinical staff should show an increase in work satisfaction and patients should show an increase in patient satisfaction. Methods: The study will take place in two maternity clinics in Germany. In line with previous studies of complex interventions, it is divided into three interdependent phases. Each phase provides its own methods and data. Phase 1: Needs assessment and a training for staff (n = 140) tested in a pre-experimental study with a pre/post-design. Phase 2: Assessment of communication training for patients and their social support providers (n = 423) in a randomized controlled study. Phase 3: Assessment of an app supporting the communication between staff, patients, and their social support providers (n = 423) in a case-control study. The primary outcome is improvement of communication competencies. A range of other implementation outcomes will also be assessed (i.e. pAEs, patient/treatment satisfaction, work satisfaction, safety culture, training-related outcomes). Discussion: This is the first large intervention study on communication and patient safety in gynecology and obstetrics integrating two theoretical models that have not been applied to this setting. It is expected that the interventions, including the app, will improve communication practice which is linked to a lower probability of pAEs. The app will offer an effective and inexpensive way to promote effective communication independent of users' motivation. Insights gained from this study can inform other patient safety interventions and health policy developments.

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Section: Introductionmentioning

confidence: 99%

Communication and patient safety in gynecology and obstetrics - study protocol of an intervention study

Lippke

Wienert

Keller

et al. 2019

BMC Health Serv Res

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“…Therefore, at times, the ANFPP was perceived to be duplicating services. Behaviours, such as ‘gatekeeping’ where a health professional may feel ownership of clients, and make decisions for their clients were at times evident [ 67 ]. In continuity of care models, such as MGPs, midwives develop strong relationships with women, often believing women trust their midwife over other service providers [ 15 , 67 ].…”

Section: Discussionmentioning

confidence: 99%

“…Behaviours, such as ‘gatekeeping’ where a health professional may feel ownership of clients, and make decisions for their clients were at times evident [ 67 ]. In continuity of care models, such as MGPs, midwives develop strong relationships with women, often believing women trust their midwife over other service providers [ 15 , 67 ]. However, after six-weeks post-natal, and during the first two years of life, the ANFPP added value to the sector – by providing continuity of care, and promoting collaborative working relationships between services at different time points for First Nations babies, women and families [ 68 ].…”

Section: Discussionmentioning

confidence: 99%

Improving interagency service integration of the Australian Nurse Family Partnership Program for First Nations women and babies: a qualitative study

Massi

Hickey

Maidment

et al. 2021

Int J Equity Health

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Background The Australian Nurse Family Partnership Program (ANFPP) is an evidence-based, home visiting program that offers health education, guidance, social and emotional support to first-time mothers having Aboriginal and/or Torres Strait Islander (First Nations) babies. The community-controlled sector identified the need for specialised support for first time mothers due to the inequalities in birthing and early childhood outcomes between First Nations’ and other babies in Australia. The program is based on the United States’ Nurse Family Partnership program which has improved long-term health outcomes and life trajectories for mothers and children. International implementation of the Nurse Family Partnership program has identified interagency service integration as key to program recruitment, retention, and efficacy. How the ANFPP integrates with other services in an Australian urban setting and how to improve this is not yet known. Our research explores the barriers and enablers to interagency service integration for the Australian Nurse Family Partnership Program ANFPP in an urban setting. Methods A qualitative study using individual and group interviews. Purposive and snowball sampling was used to recruit clients, staff (internal and external to the program), Elders and family members. Interviews were conducted using a culturally appropriate ‘yarning’ method with clients, families and Elders and semi-structured interview guide for staff. Interviews were audio-recorded and transcribed prior to reflexive thematic analysis. Results Seventy-six participants were interviewed: 26 clients, 47 staff and 3 Elders/family members. Three themes were identified as barriers and three as enablers. Barriers: 1) confusion around program scope, 2) duplication of care, and 3) tensions over ‘ownership’ of clients. Enablers (existing and potential): 1) knowledge and promotion of the program; 2) cultural safety; and 3) case coordination, co-location and partnership forums. Conclusion Effective service integration is essential to maximise access and acceptability of the ANFPP; we provide practical recommendations to improve service integration in this context.

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“…where women and children can only access medical specialists via a primary care provider, sometimes referred to as 'gatekeeper' [86,88,89]. Britt and colleagues pointed out that many insurers used ".…”

Section: Plos Onementioning

confidence: 99%

Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review

et al. 2020

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Globally, millions of women and their children suffer due to preventable morbidity and mortality, associated with both underuse and overuse of maternal and newborn care. An effective system of risk selection that differentiates between what care should be provided and who should provide it is a global necessity to ensure women and children receive appropriate care, at the right place and the right time. Poor conceptualization of risk selection impedes evaluation and comparison of models of risk selection across various settings, which is necessary to improve maternal and newborn care. We conducted a scoping review to enhance the understanding of risk selection in maternal and newborn care. We included 210 papers, published over the past four decades, originating from 24 countries. Using inductive thematic analysis, we identified three main dimensions of risk selection: (1) risk selection as an organisational measure to optimally align women's and children's needs and resources, (2) risk selection as a practice to detect and assess risk and to make decisions about the delivery of care, and (3) risk selection as a tool to ensure safe care. We found that these three dimensions have three themes in common: risk selection (1) is viewed as both requiring and providing regulation, (2) has a provider centred focus and (3) aims to avoid underuse of care. Due to the methodological challenges of contextual diversity, the concept of risk selection needs clear indicators that capture the complexity of care to make crosssetting evaluation and comparison of risk selection possible. Moreover, a comprehensive understanding of risk selection needs to consider access disparity, women's needs, and unnecessary medicalization.

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Transitioning across professional boundaries in midwifery models of care: A literature review

Cited by 18 publications

References 29 publications

Communication and patient safety in gynecology and obstetrics - study protocol of an intervention study

Communication and patient safety in gynecology and obstetrics - study protocol of an intervention study

Improving interagency service integration of the Australian Nurse Family Partnership Program for First Nations women and babies: a qualitative study

Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review

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