eurobodalla birth partners [poster] - nsw agency for ... · of the various midwifery models of care...
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![Page 1: Eurobodalla Birth Partners [poster] - NSW Agency for ... · of the various midwifery models of care and the importance of Triple ... 2 home visits with a midwife. ... Objectives (](https://reader031.vdocuments.us/reader031/viewer/2022021901/5b894c427f8b9abe1e8d509d/html5/thumbnails/1.jpg)
AcknowledgementsLisa Kennedy: Cluster General Manager Eurobodalla / Project Sponsor
Judith Hallam : Manager, Redesign & Innovation
Leanne Ovington: Director Nursing and Midwifery
Amanda Gear: Clinical Midwifery and Maternity Risk Management Consultant
Maree Hatton: Clinical Midwifery Consultant
Johanna Burke: Maternity Unit Manager, Western NSWLHD
Judith Yeo: Team leader Western Midwifery Group
Elizabeth Bennett: Maternity Unit Manager, Broken Hill
ConclusionThe project team acknowledged the importance of engaging stakeholders in planning and decision making. Collaboration and communication is key to engagement and commitment. Awareness of the various midwifery models of care and the importance of Triple Aim have improved. SNSWLHD is the only NSW health service that does not offer continuity of midwifery care. The potential for implementation aligns with state-wide “Towards Normal Birth” key performance indicators which are woman and family focused.
Case for ChangeWomen want a known midwife
SNSWLHD is the last LHD in NSW to offer a midwifery led Continuity of Care (CoC) model for pregnant women.
CoC models have proven increased satisfaction with experience of health care.
Attracts workforce, reduces complaints.
Women currently repeat their story to multiple clinicians.
Women have 1 – 2 home visits with a midwife.
Breastfeeding rates markedly decline from 93% to 31% by 4 weeks.
Diagnostics• Information given to women not standardised.
• Clinical practices not linked to policies, guidelines.
• Women see average of 16 clinicians during pregnancy
continuum.
• Average length of stay for normal vaginal birth higher
in our LHD than others of a similar size.
• Postnatal care limitations in service delivery.
• Declining breastfeeding rates:
Eurobodalla Birth PartnersWomen having a known midwife for continuity of care
Claudia Stevenson, Wendy Pryke, Angela McClelland, MUM Project Lead, CME RN/RM Project team, RM/RN Project team SNSWLHD Eurobodalla
GoalTo improve the experience and outcomes for women and their babies, ensure cost effectiveness, implement best practice models and maximise staff satisfaction.
Objectives( By August 2018 )
• Increase postnatal care > 14 days from 1% to 30%
• Improve the length of stay from 2.4 days to 1.2 days • Rates of breastfeeding at 6 months to increase from 15% to
30%
Sustaining changeEnsure aligned with Towards Normal Birth
Keep woman’s voices strong through stories,
midwives collect 2 x monthly and share
learnings at Team meetings
Continue steering meetings with consumer representative monthly
Significant change for midwives – implement evaluation checkpoints
Link PPADs with expectation of Models Of Care (MoC), provide ongoing education and develop learning needs
Introduction of new MoC , position description
Collaborate with doctors around MoC and continue case discussions
Accurate staffing levels, monthly workforce planning framework
Regular clinical supervision
ContactClaudia Stevenson [email protected] Number: 02 44 74 1524
Results
“ The option to have one or a small group of
midwives would be amazing”
“ My problem was around
communication”
Develop scope and
change
Data analysis and site
visits
Consults with women
& stakeholders
AIM tools for
change
Women's stories
Process mapping
Staff interviews
Breastfeeding appraisal tool
Triple AIM
Women and Staff
ExperiencePopulation HealthCost per Capita
The aim of having a known midwife improves safety, effectiveness, woman-centredness, timeliness, efficiency, and equity by promoting communication and
trust with a woman, resulting in less litigation for the health service
Improved team collaboration between women and clinicians resulting in
improved healthy lifestyle outcomes(e.g. smoking cessation, healthy weight
range, drug and alcohol avoidance)
I have greater job satisfaction knowing
my women
I feel listened to and this makes me feel
empowered
Methods
Planning and Implementing Solutions
YEAR DISCHARGE 6 - 8 WEEKS 6 MONTHS
2013 - 14 93% 31% 15%
2014 -15 92% 32% 24%
2015 -16 91% 31% 15%
41% 99% 50%
Postnatal care ≥ 14 days
ACM Guide lines BFHI
Education
0% 30% 20% Site visits attended by project team
Cost benefit analysis for executives
Clinical framework development in
progress
New policy guidelines in line with clinical
practice well in progress
Midwifery competencies excel
spreadsheet
Midwives using electronic documentation
for planning care
Creative rostering implemented with
postnatal home visits
“ I wishsomeone was here…”
Getting to know women and their
families is life changing
Standardise Information Given
to Women
Develop Midwifery Education
Establish Caseload Model of Midwifery Care
Increase Number of Postnatal Home
Visits
Align Clinical Practice to Policies
• Resource kit• Increase
clinical visits• Electronic
record of care plan
• Learning packages
• Update orientation package
• Onlinelearning access
• HR Systems• Caseload
rostering system
• OperationalPlan
• Promote model in community
• Union consultation
• Creativerostering
• Increase IT use for service contact
• Discharge pathway
• ‘When to call’ information kit
• Workshop on using NationalMidwifery Antenatal Care Modules and Australian College of Midwives’ Guidelines