An interactive decision-making framework (i-DMF) to scale up maternity continuity of carer models

Abstract

Background

Low numbers of women in Queensland receive continuity of care across their maternity episode. The Office of the Chief Nursing and Midwifery Officer was tasked with strengthening maternity service delivery by reviewing and improving Maternity Models of Care and Workforce.

Aim

Develop a decision-making framework (DMF) to increase maternity continuity of carer models.

Method

A literature review of models, specific to the public health maternity system, including suitability to rural areas and culturally appropriate to Aboriginal and Torres Strait Islander women was undertaken. Stakeholders informed development of the framework and toolkit. A prototype was built, tested and refined following input from rural, regional and metropolitan facilities.

Results

42 questions guide services to contextualise delivery of continuity of carer to local circumstances. Three rural sites have applied the i-DMF and toolkit. One used the tool for quality assurance of their existing midwifery continuity model, another has developed a midwifery continuity-of-carer model for Aboriginal and Torres Strait Islander women, the other is looking to establish a local rural birth service.

Conclusion

The i-DMF has potential to grow and sustain best practice maternity care, and particularly enable more women to receive relationship-based care with a known midwife.

Keywords

maternity midwifery continuity of carer relationship-based care

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References

Australian Commission on Safety and Quality in Health Care, ACSQHC (2017) The Second Australian Atlas of Healthcare Variation. Sydney: Australian Commission on Safety and Quality in Health Care. Available at: www.safetyandquality.gov.au/atlas/atlas-2017/ (accessed 1 December 2018).

Australian Government (2018) National strategic approach to maternity services. Available at: https://consultations.health.gov.au/office-of-the-chief-nursing-and-midwifery-officer/national-strategic-approach-to-maternity-services/ (accessed 30 November 2018).

Australian Health Ministers’ Advisory Council, AHMAC (2016) Final report on the National Maternity Services Plan 2010–2015. Available at: http://www.coaghealthcouncil.gov.au/Portals/0/Final%20Report%20on%20the%20National%20Maternity%20Services%20Plan%202010%20-%202015.pdf (accessed 1 December 2018).

Australian Health Ministers’ Advisory Council, AHMAC (2015) National survey of the availability of access to a midwifery carer for postnatal care outside of the hospital setting. Available at: http://www.coaghealthcouncil.gov.au/Portals/0/Reports/National%20Survey%20of%20the%20Availability%20of%20Access%20to%20a%20Midwifery%20Carer%20for%20Postnatal%20Care_uploaded%20300616.PDF (accessed 1 December 2018).

Australian Health Ministers’ Conference (2011) National Maternity Services Plan 2010. Available at: https://www1.health.gov.au/internet/main/publishing.nsf/Content/8AF951CE492C799FCA257BF0001C1A4E/$File/maternityplan.pdf (accessed 1 December 2018).

Australian Institute of Health and Welfare, AIHW (2018) Australia’s mothers and babies report 2016. Available at: https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies-2016-in-brief/contents/table-of-contents (accessed 30 November 2018).

Barclay

Kornelsen

(2016) The closure of rural and remote maternity services: Where are the midwives? Midwifery 38: 9–11.

Beck

Driscoll

Watson

(2013) Traumatic childbirth, Abingdon: Routledge.

Bogossian

(2010) An urgent call to implement systematic monitoring of a comprehensive set of quality indicators for maternity services. Women and Birth 23(1): 36–40.

10.

Brown

Weetra

Glover

, et al.(2015) Improving Aboriginal women’s experiences of antenatal care: Findings from the Aboriginal Families Study in South Australia. Birth 42(1): 27–37.

11.

COAG Health Council (2019) Woman-centred care -- strategic directions for Australian maternity services. Canberra: Department of Health. Available at: https://www.health.gov.au/resources/publications/woman-centred-care-strategic-directions-for-australian-maternity-services (accessed 8 November 2019).

12.

Collins

Fereday

Pincombe

, et al.(2010) An evaluation of the satisfaction of midwives’ working in midwifery group practice. Midwifery 26(4): 435–441.

13.

Corcoran

Catling

Homer

(2017) Models of midwifery care for Indigenous women and babies: A meta-synthesis. Women and Birth 30(1): 77–86.

14.

Creedy D and Gamble J (2018) Birth trauma and post-traumatic stress disorder. O&G Magazine 20(3). Available at: www.ogmagazine.org.au/20/23-20/birth-trauma-and-post-traumatic-stress-disorder-ptsd/ (accessed 1 December 2018).

15.

Department of Health (2016) Maternity Servcies Forum 2016. Available at: https://www.health.qld.gov.au/__data/assets/pdf_file/0031/635494/2016-maternity-forum.pdf (accessed 30 November 2018).

16.

Department of Health, Social Services and Public Safety (2012) A strategy for maternity care in Northern Ireland 2012–2018. Available at: https://www.health-ni.gov.uk/publications/strategy-maternity-care-northern-ireland-2012-2018 (accessed 30 November 2018).

17.

Donnolley

Butler-Henderson

Chapman

, et al.(2016) The development of a classification system for maternity models of care. Health Information Management Journal 45(2): 64–70.

18.

Fenwick

Sidebothama

Gamble

, et al.(2018) The emotional and professional wellbeing of Australian midwives: A comparison between those providing continuity of midwifery care and those not providing continuity. Women and Birth 31(1): 38–43.

19.

Gao

Gold

Josif

, et al.(2014) A cost-consequences analysis of a midwifery group practice for Aboriginal mothers and infants in the top end of the Northern Territory, Australia. Midwifery 30(4): 447–455.

20.

Guindo L, Wagner M, Baltussen R, et al. (2012) From efficacy to equity: Literature review of decision criteria for resource allocation and healthcare decisionmaking. Cost Effectiveness and Resource Allocation 10(9). Available at: https://research.utwente.nl/en/publications/from-efficacy-to-equity-literature-review-of-decision-criteria-fo (accessed 6 June 2019).

21.

Hirst S (2005) Re-birthing report of the review of maternity services in Queensland. Available at: https://www.health.qld.gov.au/__data/assets/pdf_file/0024/435660/maternityreview.pdf (accessed 1 December 2018).

22.

Hoang

Ogden

(2014) Women’s maternity care needs and related service models in rural areas: A comprehensive systematic review of qualitative evidence. Women and Birth 27(4): 233–241.

23.

Homer

(2016) Models of maternity care: Evidence for midwifery continuity of care. The Medical Journal of Australia 205(8): 370–374.

24.

Homer

Davis

Brodie

, et al.(2001a) Collaboration in maternity care: A randomised controlled trial comparing community-based continuity of care with standard hospital care. British Journal of Obstetrics and Gynaecology 108(1): 16–22.

25.

Homer

Foureur

Allende

, et al.(2012) ‘It’s more than just having a baby’ women’s experiences of a maternity service for Australian Aboriginal and Torres Strait Islander families. Midwifery 28(4): e509–e515.

26.

Homer

Matha

Jordan

, et al.(2001b) Community-based continuity of midwifery care versus standard hospital care: A cost analysis. Australian Health Review 24(1): 85–93.

27.

Josif

Barclay

Kruske

, et al.(2014) ‘No more strangers’: Investigating the experiences of women, midwives and others during the establishment of a new model of maternity care for remote dwelling aboriginal women in northern Australia. Midwifery 30(3): 317–323.

28.

Kildea

McGhie

Gao

, et al.(2015) Babies born before arrival to hospital and maternity unit closures in Queensland and Australia. Women and Birth 28: 236–245.

29.

Kildea

Tracy

Sherwood

, et al.(2016) Improving maternity services for Indigenous women in Australia: Moving from policy to practice. Medical Journal of Australia 205(8): 374–379.

30.

Kruske

Schultz

Eales

, et al.(2015) A retrospective, descriptive study of maternal and neonatal transfers, and clinical outcomes of a Primary Maternity Unit in rural Queensland, 2009–2011. Women and Birth 28(1): 30–39.

31.

Leinweber

Creedy

Rowe

, et al.(2017) Responses to birth trauma and prevalence of posttraumatic stress among Australian midwives. Women and Birth 30(1): 40–45.

32.

Longman

Kornelsen

Pilcher

, et al.(2017) Maternity services for rural and remote Australia: Barriers to operationalising national policy. Health Policy 121(11): 1161–1168.

33.

Lucas

Charlton

Brown

, et al.(2015) Review of patient satisfaction with services provided by general practitioners in an antenatal shared care program. Australian Family Physician 44(5): 317–321.

34.

McLachlan

Forster

Davey

, et al.(2012) Effects of continuity of care by a primary midwife (caseload midwifery) on caesarean section rates in women of low obstetric risk: The COSMOS randomised controlled trial. BJOG 119(12): 1483–1492.

35.

National Health Service, NHS (2017) Implementing Better Births: Continuity of Carer. Five Year Forward View. Available at: https://www.england.nhs.uk/wp-content/uploads/2017/12/implementing-better-births.pdf (accessed 1 December 2018).

36.

Organisation for Economic Co-operation and Development, OECD (2018) Health Statistics at a Glance. Available at: http://www.oecd.org/els/health-systems/health-data.htm. (accessed 30 November 2018).

37.

Priddis

Keedle

Dahlen

(2018) The perfect storm of trauma: The experiences of women who have experienced birth trauma and subsequently accessed residential parenting services in Australia. Women and Birth 31(1): 17–24.

38.

Queensland Health (2016) Queensland perinatal statistics (preliminary). Available at: https://www.health.qld.gov.au/hsu/peri/peri2016/report2016 (accessed 13 September 2018).

39.

Queensland Health (2018a) The health of Queenslanders. Report of the Chief Health Officer 2018. Available at: https://www.health.qld.gov.au/__data/assets/pdf_file/0032/732794/cho-report-2018-full.pdf (accessed 30 November 2018).

40.

Queensland Health (2018b) Maternity and neonatal clinical guidelines. Available at: https://www.health.qld.gov.au/qcg/publications (accessed 30 November 2018).

41.

Rural Doctors Association of Queensland, RDAQ (2018) Rural Birthing Services Safest Solution. Available at: https://www.rdaq.com.au/news/rural-birthing-services-safest-solution-rdaq (accessed 1 December 2018).

42.

Renfrew

McFadden

Bastos

, et al.(2014) Midwifery and quality care: Findings from a new evidence informed framework for maternal and newborn care. The Lancet 384(9948): 1129–1145.

43.

Sandall

Soltani

Gates

, et al.(2016) Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 15(9): CD004667.

44.

Scottish Government (2017) The Best Start: Five-Year Forward Plan for Maternity and Neonatal Care. Available at: https://www.gov.scot/publications/best-start-five-year-forward-plan-maternity-neonatal-care-scotland/ (accessed 30 November 2018).

45.

Smith

(2017) Burnout in obstetricians and gynecologists. Obstetrics and Gynecology Clinics of North America 44(2): 297–310.

46.

Toohill J, Fenwick J, Sidebotham M, et al. (2019) Trauma and fear in Australian midwives. Women and Birth 32(1): 64--71.

47.

Toohill

Gamble

Creedy

(2013) A critical review of vaginal birth rates after a primary caesarean in Queensland hospitals. Australian Health Review 37(5): 642–648.

48.

Toohill

Turkstra

Gamble

, et al.(2012) A non-randomised trial investigating the cost-effectiveness of Midwifery Group Practice compared with standard maternity care arrangements in one Australian hospital. Midwifery 28(6): e874–e879.

49.

Tracy

Hartz

Tracy

, et al.(2013) Caseload midwifery care versus standard maternity care for women of any risk: M@NGO, a randomised controlled trial. The Lancet 382(9906): 1723–1732.

50.

Tracy

Welsh

Hall

, et al.(2014) Caseload midwifery compared to standard or private obstetric care for first time mothers in a public teaching hospital in Australia: A cross sectional study of cost and birth outcomes. BMC Pregnancy and Childbirth 14(1): 46 Available at: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-46 (accessed 1 December 2018).