Delivering continuity of midwifery care to Queensland women

Paramount to the success of the model is development of values and vision that is shared
within the entire maternity unit. A short, clear mission statement ensures a consistent
message is provided for communication both within the unit and to external stakeholders.
Successful communication involves:
• identifying key multidisciplinary leaders who can influence change within the service
• open dialogue within the service is required to identify the level of support for midwifery
continuity of care models
• demonstrating a positive commitment to inclusion, shared decision making and problem
solving and identifying barriers.
Securing a senior level sponsor for the development of the model is important and provides
a shared responsibility for success. It is strategically effective to have communication and
discussion within the organisation led by a person in a position of influence who can provide
guidance in relation to strategies and available resources and who can keep the model on
the agenda at Hospital and Health Service (HHS) and state-wide meetings.
Effective communication relies on ensuring everyone has:
• been identified for inclusion in the steering committee for the model (see Engaging
Stakeholders below)
• access to information: proposal shared, minutes of meetings are available and displayed,
information sessions provided, newsletters distributed
• opportunities to contribute: genuine representation within planning or management
groups
• processes for clarification: consultation has occurred at a number of levels and times (J.
Toohill personal communication, February 14, 2011).
Expectations
Based on the philosophy and model developed, staff working in these models will need to
have a clear picture of what they can expect.
• What is the arrangement for handing over care, by what means and with whom
• When and where are clinical outcomes recorded and audited
• Who and how can collaborating staff be contacted regarding variations in a woman’s
health
• How will staff respond when women choose to take a different path to that which is
recommended
Communication of these expectations leaves staff with clarity about their roles. It is
important to document role delineation so that if situations arise where staff members act
outside of the parameters expected of them, there are opportunities for early resolution of
difficulties.
Bumps and blocks
The entire team needs to be involved in planning communication processes. In one
MGP model obstetricians were unable to attend regular collaborative clinical meetings
with the midwives because the administration team had changed the obstetric rosters.
Despite seeking rectification of this, senior administrators seemed not to comprehend the
importance of these meetings to the sustainability of the model by maintaining collegial
interdisciplinary relationships and maintaining clinical safety. This resulted in internal
conflict and major difficulties for the service. Significant discussion and an entirely new way
of approaching collaborative meetings (new time, new people involved, quicker processes)
was required to resolve the situation.
A range of communication strategies are outlined in Section 10 and Section 11.
A guide to implementation
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