Delivering continuity of midwifery care to Queensland women

Key Performance Indicators
Clinical outcome comparison and benchmarking with other services provides the most
relevant and straightforward evaluation of a model. Key Performance Indicators will be
decided by the steering committee and will be relevant to the local context. See Appendix
6.02 for the list of statewide KPIs agreed by NMOQ for midwifery models.
Professional development
Continuing professional development is essential both from a regulatory perspective
and from a governance perspective. Midwives’ individual professional development and
capacity building for midwifery as a whole is discussed in Section 9.
Credentialing
Within the medical profession ‘credentialing’ refers to a process which verifies the
education, experience and clinical skills of a medical practitioner seeking employment or
access to a hospital or health facility. Within midwifery, the term has been loosely used to
describe determining clinical competence in a range of skills.
The Australian Commission on Safety and Quality in Health Care (ACSQH) has produced a
national guideline on credentialing. It is important that credentialing processes within and
outside Queensland Health are consistent and that they are also consistent with processes
to credential medical or allied health practitioners.
Credentialing of eligible midwives is discussed in Section 13.
Research and development
Midwifery Group Practice provides an ideal setting for ongoing research and development
in midwifery care. It is important that midwifery models maintain links to universities and
participate in research and publication of innovations and outcomes.
Queensland Health provides ongoing support to research through Clinical and Statewide
Services: Coordination Planning and Research Unit. See: www.health.qld.gov.au/qhcss/
research/info.asp
Complaints management
Processes are required for women to provide feedback about their care and for midwives
to raise concerns about the model, unit or other elements of care. Several complaints
processes exist in Queensland for both. Consistency across areas of Queensland Health
needs to include maternity units.
Information regarding complaints management can be found at:
For consumers: www.health.qld.gov.au/quality/consumer_complaints/complaints.asp
and www.hqcc.qld.gov.au
For staff: www.health.qld.gov.au/nonconsumer_complaint/docs/sclo_brochure.pdf
Evidence-based practice
Maternity care has long been criticised as an area where practice has been based on
customary practices rather than research and evidence (Cochrane 1979; Freeman, Adair,
Timperley, & West 2006). An example of this is the use of continuous cardiotocographic
(CTG) monitoring in low risk women. Despite no evidence to support the use of CTGs in
women without identified risks (National Collaborating Centre for Women’s and Children’s
Health 2007), extensive use in normal labour is prevalent.
Evidence-based practice must underpin models of midwifery care and care provided by all
health care professions. Midwifery Group Practice and continuity of care produces exceptional
outcomes (Appendices 1.02 and 1.03). The development of policies and clinical guidelines for
Midwifery Group Practice models within Queensland Health requires critical analysis of current
documents and adaptation if necessary. All policies and clinical guidelines need to be living
documents which require updating as new evidence becomes available.
A guide to implementation
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