A qualitative context analysis using the Consolidated Framework for Implementation Research was conducted at a single-site tertiary health facility in Queensland, Australia. We wish to acknowledge Tristan Elder as his administrative assistance with this study was invaluable. volume22, Articlenumber:1265 (2022) Coburger Strasse 31, Grub am Forst, 96271. Wollongong Hospital Carpark: Access to the North and South Carpark entrances via New Dapto Road or Dudley Street. Most participants were female (87%) and between 41 and 50 years of age (35.5%). Midwifery. 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. They were predominantly permanent employees (74.2%) and had more than 10 years experience (70.9%) (Table2). The authors declare no conflicts of interest are held in relation to this study. Born on April 27, Emme Millard claimed the precious title of the first baby born with the assistance of the TMGP, which formed earlier this year. You are on ISLHD's test/development site. There were a number of different terms used to define the model of care, and the level of continuity provided across the continuum of care varied with no single term used. Processes that demonstrate evidence of planning and reflecting across all CFIR domains, especially regarding linkages between different health professional disciplines and costs, are also important. BMC Health Serv Res. Maternity services have limited formalised guidance on planning new services such as midwifery group practice for vulnerable women, for example women with a history of substance abuse (alcohol, tobacco and other drugs), mental health challenges, complex social issues or other vulnerability. Participants also suggested ways to address the womans disengagement through awareness and actions by the midwives: We have to be open and transparentso theres a consistent approach and that we can be strong and recognise it when it (disengagement) happens and maintain the relationship (Midwife, Interview 10). Whilst some MGPs are already established there is no ability to be engaged concomitantly with the antenatal model of care available to vulnerable women [36]. 2012;28(2):16372. 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. THE new Tweed Midwifery Group Practice (TMGP) has welcomed the birth of its first baby. Stakeholders perceived that there was high quality and valid evidence supporting midwifery group practice for vulnerable women as gold standard care (Midwife, Interview 2). The Indigenous Birthing in an Urban Setting study: the IBUS study: A prospective birth cohort study comparing different models of care for women having Aboriginal and Torres Strait Islander babies at two major maternity hospitals in urban South East Queensland, Australia. The way that MGPs are managed could be an important factor in whether they are successful in the long-term. MGP midwives allocate new clients once a month. Article Implement Sci. However, such a model of care is rarely available for Australian women with complex social circumstances or with specific cultural or other needs [11]. 1). Privacy Midwives will actually see this as a positive move and its going to be development for them, and its going to be opportunistic for them (Nurse/Midwife Leader, Interview 4). 2020;56:2634. Potential barriers and enablers were identified from the interview data and grouped into themes: the womans experience, midwifery workforce, gold standard care, the interdisciplinary team, and costs. Perceptions around cost that are both potential enablers and barriers to gaining support and successful implementation would need to be clarified as fact in a business case before the proposed model is implemented. New Z Coll Midwives J. 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. PER 101. Participants had concerns around costs which may be reflected by decision-makers when examining the rigor in which a business case has been prepared. Midwives are able to acquire and maintain the skills . Midwives may work in public hospital MGPs, or those from other sectors including private practice and in Aboriginal medical services. Maternity care in Australia: first national report on models of care, 2021. How health care setting affects prenatal providers risk reduction practices: a qualitative comparison of settings. Find out more about our policy and your choices, including how to opt-out. It is also unknown how accepted midwifery group practice is amongst key stakeholders in Australia. Participants believed that the health benefits of the proposed model of care would outweigh the perception that a midwifery group practice for vulnerable women was a more expensive model of care. Raatikainen K, Heiskanen N, Heinonen S. Under-attending free antenatal care is associated with adverse pregnancy outcomes. MGP midwives work . Marsh CA, Browne J, Taylor J, Davis D. Making the hidden seen: A narrative analysis of the experiences of Assumption of Care at birth. continuing to have the multi-disciplinary input and multi-disciplinary team meeting is going to be beneficial (Medical Officer, Interview 20). The CFIR has demonstrated applicability to data collection, analysis and implementation within maternity settings [34, 35] and provided a practical framework to assess the multiple factors involved in planning for a new midwifery group practice for vulnerable women. Computer-assisted analysis was undertaken to mitigate the recognised and acknowledged potential inherent bias in qualitative analysis [41]. If you cannot be seen by the MGP program, we have other pregnancy clinics that may suit you. Aim: To explore what determines optimal management of MGP in Australia, and . Midwifery Group Practice | Gold Coast Health Many participants expressed empathy for the likely patient cohort and placed the proposed model as a high priority for the health service. While womens disengagement from the proposed model might be identified as a risk, in discussions around this barrier solutions were identified. If complications arise during or after the birth, you and your baby will be admitted to our Maternity Inpatient Unit (MIPU). These midwifery group practices cater for only a small proportion of vulnerable pregnant women and so many other women continue to have antenatal care that does not meet their needs. Midwifery. 2007;45(2):4157. 2009;4(1):50. Family planning and wellness education. 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). There was recognition that the proposed model of care is supported by research and a view that clinical benefits will outweigh costs, however supervision and support is required for midwives to manage and limit vicarious trauma. Referrals to the service can be made through a general practitioner or by self-referring by calling the Tweed Hospital Women's Care Unit on (07) 5506 7490. 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 Bayrampour H, McNeil DA, Benzies K, Salmon C, Gelb K, Tough S. A qualitative inquiry on pregnant womens preferences for mental health screening. 2012;28(6):e874-9. Home > For Women > Midwifery Group Practices. Womens views and experiences of having their mental health needs considered in the perinatal period. 8:30am-12:00pm on Fridays. Effective processes and strategies used to implement a midwifery group practice for vulnerable women depend on full engagement of stakeholders and a clear picture of the health service context [30, 31]. Midwifery Group Practice. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. 76024 Suite 1/118 Main Street Murwillumbah | 6672 1698. If we can offer you a place on the program a midwife will contact you by phone. There are 8000 staff on campus encompassing a multitude of complex health services [34] This study setting was selected as midwifery managers sought to improve accessibility of care delivered to vulnerable women, acutely aware of a high failure-to-attend rate where more than 25% (n=205) of vulnerable women do not attend their scheduled antenatal care compared to 8% in the general population each year (unpublished health service data available on request). Of the 40 people invited to an interview, 31 consented to participate (77.5%) with no response received from 9 others. This is supported by comments from participants: vulnerable or disadvantaged groups would benefit (Other role, Interview 1). Our MGP program offers you one midwife (who works in a team) who will care for you through your pregnancy, through your birth and at home for 2 weeks after your baby is born. Aust N Z J Obstet Gynaecol. Google Scholar. CAS Background information included one sentence about the evidence for midwifery group practice being an appropriate solution for vulnerable pregnant women and the purpose of the study and risks and benefits of participating. Risk management assessment indicates the need to identify likely barriers and enablers. Notes were also made by the interviewers. J Manage Control. Midwifery Group Practice. Leximancer 4 generated themes from stakeholder interviews. Our staff can also ask for an interpreter. Your request for care will be considered when you are around 12-14 weeks pregnant. Our guests praise the breakfast in our reviews. Women should apply for MGP care if they are: This demonstrates that individuals knowledge and beliefs about the intervention was a strong enabler for proceeding with the proposal. Arch Gynecol Obstet. Cost-effectiveness of public caseload midwifery compared to standard Cretchley J, Rooney D, Gallois C. Mapping a 40-year history with Leximancer: Themes and concepts in the Journal of Cross-Cultural Psychology. 2015;52(8):133242. Birth. Quality evidence drawn from Australian studies [10, 13] builds confidence amongst stakeholders, which is a strong enabler. MGP is located at the Wollongong Hospital and has an antenatal service at Shellharbour Hospital. A midwifery team for high-risk pregnancies - PubMed Support for the inclusion of an interdisciplinary team in the proposed model of care was identified as an enabler and was particularly supported by non-midwife participants: I would love it, because we felt [from observation of previous staffing arrangements] that when the midwives were staying in the role longer it felt very organised and that we knew the patients very well (Allied Health Practitioner, Interview 9). Midwifery group practice is also safe in terms of maternal and neonatal outcomes, is associated with a reduction in maternal risk-taking behaviours, and is a less-costly model of maternity care [24,25,26]. 1) Confirm your pregnancy. Midwife, Registered Nurse, Medical Officer and more on Indeed.com Midwifery Group Practice $75,200 Jobs in New South Wales (with Salaries) 2022 | Indeed.com Australia 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]. PubMed Central Whilst participants were sent relevant information containing brief background to the proposed study in advance of the interview, some attendees advised they wanted to come well prepared. BMC Health Serv Res 22, 1265 (2022). Peer checking was undertaken independently (by CK) through analysis of the de-identified research transcripts using Leximancer V4. In an emergency, please contact the Mater Mothers' Hospital Birthing Suites on telephone 07 3163 7000 (all hours). Women Health. Article Feedback on study results at completion of the study was provided to participants who requested follow-up. Instead, our interpretation of results for Australian maternity services should prompt services to identify which of our results mapped to the CFIR domains are relevant, and how they might be similar or different to the local context. Women Birth. A midwife or small team of midwives will provide your primary care with medical practitioner. The theme Gold standard care mapped to five constructs indicates that either a perception, or knowledge of evidence supporting midwifery group practice for vulnerable women would be critical to its success. Enablers included perceptions of improved clinical outcomes, building of safety and trust, patient satisfaction and the potential to reduce fail to attend rates at the specialty clinic. 2002;109(3):26573. CK: Methodology (Leximancer), Formal analysis, Data curation, Writing Original Draft, Review and Editing. Flinders University . 2023-03-17 09:56:17. Midwifery Group Practices (MGPs) provide care to pregnant women in a group of (4-6) midwives. Some MGPs in certain states also provide public-funded homebirth programs. Caseload midwifery care versus standard maternity care for women of any risk: M@NGO, a randomised controlled trial. In the United Kingdom, smokers were significantly more likely to have a late booking appointment after 18 weeks gestation (Odds Ratio 1.6) [6]. Midwifery caseload practice Group pregnancy care Young Mums Privately Practising Midwife Antenatal Shared Care Other links for women preparing to birth at Westmead Westmead midwives understand each pregnancy is unique and our care includes education to help you remain healthy and well throughout your pregnancy 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. Some participants had undertaken self-directed reading to source additional information regarding midwifery group practice and the needs of vulnerable women. Midwifery Group Practice (MGP) care is offered to women with no to moderate complicating health factors, who wish to have a normal birth. Discussion around the womans experience identified enablers for the proposed model. Choosing a qualitative data analysis tool: A comparison of NVivo and Leximancer. 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). Diabetes Res Clin Pract. Relationships between women and carers that are grounded in an interdisciplinary continuity of care and carer model increases womens access to services and provide safe spaces for disclosure of sensitive information that guides high quality health care delivery [19]. Midwifery. Birth Centre: Midwifery-led care for low- to medium-risk women who want minimal intervention with their labour and birth. SLHD - RPA- Women and Babies Ambulatory Care - Information for Pregnant Below is the link to the electronic supplementary material. We aimed to identify the potential barriers and enablers for implementing a midwifery group practice for vulnerable women. The identification of this enabler suggests that the initial enthusiasm for the intervention would sustain its implementation over time. per night. 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. Existing maternity services may not meet the needs of vulnerable women during pregnancy, resulting in non-attendance of scheduled antenatal care and raising the risk of poor maternal and neonatal outcomes [5]. The two novice researchers, both dual registered nurses and midwives at senior and middle management levels were known to all participants. NEW mothers can expect the best of care at the new Tweed Midwifery Group Practice. * Your GP will refer you to the Antenatal (Pregnancy) Clinic, but please also fill out a form for the MGP team (Step 2 below). Participants were also advised their involvement was voluntary and that their responses could be withdrawn at any stage up to two-weeks post-interview. Allen J, Gibbons K, Beckmann M, Tracy M, Stapleton H, Kildea S. Does model of maternity care make a difference to birth outcomes for young women? "This model of care is backed by very strong evidence for the benefits it brings to women and babies, and is a very exciting addition to The Tweed Hospital, director of nursing and midwifery Susan Freiberg said. Our care principle is based on the midwifery philosophy that childbirth is a normal process. PS: Conceptualization, Methodology, Investigation, Formal analysis, Writing Original Draft, Review submission. 2015;51:116. About us Brisbane: Queensland Government; 2021 [Available from: https://metronorth.health.qld.gov.au/rbwh/about-us. Not all stakeholders may be supportive and there may be less-visible aspects of the health service that may make sustained implementation of a midwifery group practice for vulnerable women difficult. Thematic analysis of qualitative research data: Is it as easy as it sounds? The study was deemed by the Royal Brisbane and Womens Hospital and Queensland University of Technology Human Research Ethics Committees as a quality assurance or quality improvement activity and thus not requiring ethics review (Exemption number: LNR/2019/QRBW/54360). Patricia A Smith. PDF Pilot Model Annualised Salary Agreement for Midwifery Group Practices Midwifery Group Practice | Queensland Health 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. Midwifery. Themes identified were the womans experience, midwifery workforce capabilities, identifying gold standard care, the interdisciplinary team and costs. Patients and visitors Our services The Tweed Practice The Tweed Practice Details and latest news from The Tweed Practice can be found on the Hay Lodge Health Centre website. PubMed Tracy SK, Hartz DL, Tracy MB, Allen J, Forti A, Hall B, et al. This is known as continuity of care. BMC Health Serv Res. Tweed Valley Weekly, May 25, 2017 - Issuu Midwifery Group Practice (MGP) allows women and families having a baby to be cared for by a known midwife throughout their pregnancy, during labour and birth, and postnatally. Midwifery Group Practice is a continuity of care model for pregnant women who provide individualised care through her antenatal (pregnancy), intra partum (labour and birth) and early postnatal journey.
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