The 1000-bed health service is located in an inner suburb of an Australian capital city, with a diverse population catchment including large numbers of disadvantaged groups. Potential enablers of implementation included perceptions that the model facilitates a relationship of trust with vulnerable women, that clinical benefit outweighs cost and universal stakeholder acceptance. California Privacy Statement, The researchers conferred to agree on a joint understanding of the themes which emerged. Midwifery Group Practice program Vulnerable pregnant women in antenatal practice: Caregivers perception of workload, associated burden and agreement with objective caseload, and the influence of a structured organisation of antenatal risk management. Information received by email post-interview was collated for de-identification and included in the analysis. The participants identified through purposeful sampling [37] were sent invitations including an information sheet providing a brief background to the study, via email, with open invitations also promoted at staff meetings. About Midwifery Group Practices Sometimes known as 'Caseload Midwifery', Midwifery Group Practice (MGP) is the work unit of caseload midwives enabling women to be cared for by the same midwife (primary midwife) supported by a small group of midwives throughout their pregnancy, during childbirth and in the early weeks at home with a new baby. Opened at the Tweed Hospital in March, the new model of midwifery care provides women the opportunity to be seen by the same midwife from their first antenatal visit right through their pregnancy, during birth and after they have returned home with their baby. * send the MGPform aboveto this address:ISLHD-TWHAntenatalServices@health.nsw.gov.au. Shellharbour Hospital Carpark: Access to car parking facilities via the Hospital entrance on Madigan Boulevarde. (Midwife, Interview 6). 9:00am-6:00pm on Mondays, Wollongong Hospital Continuity of care and carer is known to provide many benefits in terms of the health outcomes of mothers and babies and the levels of satisfaction of care for both consumers and care providers [10]. For maternity services seeking to implement a midwifery group practice for vulnerable women, our results can be leveraged to further investigate other local contexts, and quickly identify strategies for effective and sustained implementation of the new model of care [48]. Consequently, there may have been fewer inner setting barriers to establishing the proposed model of care compared to Australian maternity services in which midwifery group practice is new or not yet established. The benefits of continuity of care and carer are well documented [10] and are likely to be seen in vulnerable women. Data were analysed using manual and then Leximancer computer assisted methods. The identification of this enabler suggests that the initial enthusiasm for the intervention would sustain its implementation over time. The difficulty in attracting midwives to the proposed model of care was an identified barrier to implementing a high standard of care: attracting the midwives that would have an interest in it, we almost need a mother-like figurewould have to be resilient and have had a few more life experiences (Medical Officer, Interview 13). Active pursuit of the voices of consumers and staff from a representative range of backgrounds in planning new models of maternity care across Australia is recommended by the researchers. Midwifery Group Practice | Queensland Health Midwifery Group Practice | Northern NSW Local Health District 2012;52(6):57681. Roslyn Donnellan-Fernandez . The MGP model of care provides continuity of maternity care by a known midwife throughout pregnancy, labour and birth, and the early weeks following the birth of your baby. Terms and Conditions, Midwifery Group Practice - Brigham and Women's Hospital Participants saw the proposed new model as an opportunity for midwives to gain new skills and expand their scope of practice which was identified as an enabler: There are a few midwives out there currently upskilling themselves and are really passionate and interested and already preparing for being part of the team (Nurse/Midwife Leader, Interview 3). 2020;56:2634. EM: Methodology, Writing Original Draft, Supervision. Your primary care will be provided by a midwife or a small team of midwives in partnership with a GP Obstetrician. Armadale Health Service - Midwifery Group Practice The Midwifery Group provides: Prenatal care. A train service is close by for women attending Wollongong Hospital and a public carparking service is available at both Wollongong and Shellharbour. As this study was carried out in a facility with established and supported midwifery group practices, caution should be applied in generalising the specific local results to other services for which midwifery group practice is a new concept. some with abuse histories dont want to go over those histories over and over. 2018;28(5):82431. Two strategies for qualitative content analysis: An intramethod approach to triangulation. However, if the need for medical consultation or . Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Themes identified were the womans experience, midwifery workforce capabilities, identifying gold standard care, the interdisciplinary team and costs. The CFIR outlines domains and constructs that are associated with effective implementation of new interventions. They would also provide professional support for midwives who might feel isolated in their role. Midwife-centred management: a qualitative study of midwifery group For most women your group of midwives will be able to provide the majority of your care. Our care principle is based on the midwifery philosophy that childbirth is a normal process. Forster DA, McLachlan HL, Davey MA, Biro MA, Farrell T, Gold L, et al. You will be contacted by them if you are able to be fitted into the program. Implementation barriers and enablers of midwifery group practice for vulnerable women: a qualitative study in a tertiary urban Australian health service, https://doi.org/10.1186/s12913-022-08633-8, https://www.pretermalliance.com.au/Alliance-News/Latest-News/Midwifery-Continuity-of-Care, https://metronorth.health.qld.gov.au/rbwh/about-us, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, bmchealthservicesresearch@biomedcentral.com. Discussion around the womans experience identified enablers for the proposed model. BMC Pregnancy Childbirth. There is strong international evidence that these womens pregnancies are more likely to result in placental abruption, preterm birth, neonates that are small for gestational age, and neonatal admission to an intensive care unit [3, 4]. Australias mothers and babies. This may also influence future expansion of midwifery group practice as a model of care more generally. Midwifery Group Practice (MGP) continuity of care is where the woman and her family know the midwives who provide her care through pregnancy, labour, birth and at home after the baby is born. The women can be fearful about opening upthat there may be negative consequences (Midwife, Interview 10). PubMed The framework has five domains that reflect key elements of a health service that need to be investigated before implementing change in an established interdisciplinary service. "It's what midwifery is all about": Western Australian midwives Below is the link to the electronic supplementary material. Opening Times: Monday to Friday 09:00 - 18:00 Share this page Twitter Facebook Contact NHS Borders As patterns emerged in the reassembling of data and coding, recurrent themes were identified to enable thematic analysis [38]. ISLHD-TWHAntenatalServices@health.nsw.gov.au. Midwifery Group Practice Ward Clerk (08) 8161 8406 (Monday - Friday, 9.00am - 3.30pm) Fax (08) 8161 7829 Email Health.WCHNMidwiferyGroupPracticeWdClrk@sa.gov.au Mailing Address Midwifery Group Practice Women's and Children's Hospital 72 King William Road North Adelaide South Australia 5006 Pregnancy Services at the WCH * Your GP will refer you to the Antenatal (Pregnancy) Clinic, but please also fill out a form for the MGP team (Step 2 below). BMC Health Services Research 2018;65:815. When mapping the themes to the CFIR domains, the implications of local results to Australian maternity services became evident. Demographic data were collected from all participants by a written survey at the interview to provide an overview of participants characteristics. Overall, the most common terms were caseload midwifery (n = 63, 36%), midwifery-led continuity (n = 60, 34%), or team/midwifery group practice (n = 40, 23%). We are proud of our long tradition of providing sensitive, thorough care for women. Midwives may work in public hospital MGPs, or those from other sectors including private practice and in Aboriginal medical services. Please contact us to discuss fees, Medicare rebates, the Pharmaceutical Benefits Scheme, etc Illawarra and Shoalhaven Local Health District, https://www.islhd.health.nsw.gov.au/services-clinics/welcome-division-maternity-and-womens-health/mgp, Welcome to the Division of Maternity and Women's Health, Click here for more information about theIllawarra Health Care Interpreter Service, Antenatal (Pregnancy) Care - Milton Ulladulla Hospital, Antenatal (Pregnancy) Care - Shoalhaven Hospital, Antenatal (Pregnancy) Clinic - Wollongong Hospital, Antenatal (Pregnancy) Shared Care with your GP, Childbirth & Early Parenting Education - groups and videos, Early Pregnancy Assessment Service (EPAS), Maternity Ward (C2 West) - Wollongong Hospital, Midwifery Group Practice (MGP) - Wollongong, Neonatal (Baby) Unit - Shoalhaven Hospital, Neonatal (Baby) Unit - Wollongong Hospital, Coronavirus (Covid-19) - Pregnancy and Breastfeeding, Diabetes in pregnancy- Gestational (GDM), Type 1 or Type 2, Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum (HG), Resources and brochures - pregnancy, baby, other languages. In Finland, women who smoked and consumed alcohol were significantly more likely to receive insufficient antenatal care defined as between zero and five visits (Odds Ratios 1.87 and 1.48 respectively) [7]. Byron Bay Midwife Services - Home Quality evidence drawn from Australian studies [10, 13] builds confidence amongst stakeholders, which is a strong enabler. Nagle U, Farrelly MJM. Midwifery and midwifery group practice is recommended for all vulnerable women [12, 14,15,16] because of improved health outcomes for both mothers and babies. 2021;21(1):113. Stakeholders had a positive attitude towards the intervention; they placed a high value on the proposed model of care. Participants were mostly clinicians with more than 10 years experience and so were likely able to make accurate assumptions around the number of workforce hours required to build rapport with women, discuss the care being delivered with the women and amongst colleagues, and deliver the volume of care required to optimise health outcomes. Further, the interdisciplinary team engaged in this research was supportive of midwifery group practice. BMJ Open. Not a magic bullet: Byron holiday rental cap backlash, NRRRL: massive grand final rematch, huge comeback victory. Flinders University . The Midwifery Group Practice (MGP) is a free service offered by Gold Coast Health and is located within the Birth Centre at the Gold Coast University Hospital. The midwife researchers reflected on and acknowledged both the potential bias of being midwives investigating a topic they may have a self-interest in, along with the benefits of improved engagement from participants as they were known colleagues. Risk management assessment indicates the need to identify likely barriers and enablers. Women should apply for MGP care if they are: The State of Queensland (Queensland Health) 2023, www.goldcoast.health.qld.gov.au | | _v1_, Gold Coast Health is recognised for quality patient care, nursing and midwifery excellence and innovations in professional nursing and midwifery practice under the, Aboriginal & Torres Strait Islander service, Aboriginal and Torres Strait Islander Health, Services, Emergency Contacts and Resources, Lesson 1 - Using language strategies in everyday routines, Feeding babies for women isolated and quarantined, Partner with the National Centre for Neuroimmunology and Emerging Diseases. Professional interpreters are available if you need help to communicate with staff. Birth. Sometimes known as Caseload Midwifery, Midwifery Group Practice (MGP) is the work unit of caseload midwives enabling women to be cared for by the samemidwife(primary midwife) supported by a small group of midwives throughout their pregnancy, during childbirth and in the early weeks at home with a new baby. 2019;32(1):e111. The consolidated framework for implementation research 2019 [Available from: https://cfirguide.org/. Many participants expressed empathy for the likely patient cohort and placed the proposed model as a high priority for the health service. Renz SM, Carrington JM, Badger TAJQhr. 2) You also fill out this referral form and send to MGP team. Participants were also invited to provide further information via email at their convenience, but transcripts would not be returned to comments for comment or correction. 8:30am-12:00pm on Fridays. Consolidated Framework for Implementation Research. Implement Sci. NEW mothers can expect the best of care at the new Tweed Midwifery Group Practice. Independent analysis and consistency of results further enhances the credibility and trustworthiness of the study, along with research reflexivity throughout the study. An interdisciplinary team that is already part of the organisational structure and engaged in planning the model is likely to be essential. The midwife researchers (PS and DR) concluded in their reflections that the broad range of disciplines from which participants were drawn resulted in very positive engagement from the team and enhanced marketing of the proposed change in service delivery. Where it is not possible to be seen by your own midwife, another midwife from MGP will see you. 2002;109(3):26573. Quicklinks. Faculty of Medicine, Nursing and Health Sciences . Continuity of midwifery care (Midwifery Group Practice)your care is provided by a midwife during your pregnancy, when have your baby and for up to 6 weeks after the baby is born. There are criteria around this involving your general health, obstetric history and your current address. Further, that demonstrated engagement in the context assessment by stakeholders was an indicator that individuals were at an advanced stage of change in relation to redesigning maternity care for vulnerable women. However, potential barriers centred around concerns that women may disengage if they did not bond with the known midwife, were socially isolated or feared being reported to child safety services: For the women its positive all around, unless they felt they couldnt engage with the midwife, which could lead to the women disengaging completely. Your request for care will be considered when you are around 12-14 weeks pregnant. 2015;28(4):28592. MGP is gold standard and theres lots of research out there that shows that continuity of care is best for these women to develop a relationship (Midwife, Interview 2). Conducting the context assessment instilled confidence in readiness of the maternity service to adopt the proposed change. An alternative to this is Midwifery Group Practice (MGP), also called continuity of midwifery or caseload midwifery which has been implemented globally and largely focusses on low-risk pregnancies [10, 13]. Stakeholders perceived that there was high quality and valid evidence supporting midwifery group practice for vulnerable women as gold standard care (Midwife, Interview 2). Review submission. Choosing implementation strategies to address contextual barriers: diversity in recommendations and future directions. Midwifery. All data were de-identified in preparation for data analysis. its an addition to the multi-disciplinary teams, so it doesnt take anything away but theyve got some-one they can trust that follows them through all the way (Medical Officer, Interview 8). These committees also determined that informed consent was not required to be obtained from participants, and only a participant information sheet was provided. Toohill J, Turkstra E, Gamble J, Scuffham PA. A non-randomised trial investigating the cost-effectiveness of Midwifery Group Practice compared with standard maternity care arrangements in one Australian hospital. We aimed to identify the potential barriers and enablers for implementing a midwifery group practice for vulnerable women. PubMed BMC Pregnancy Childbirth. The second analysis was compared with themes from first round analysis thus establishing findings across three researchers using two methods, and substantiating trustworthiness in the study [44]. 2018;18(1):309. Thirteen individual interviews and 7 group sessions were held over a months period in 2019 on-site at the facility.
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