Delivering continuity of midwifery care to Queensland women

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Award levels for midwives Often midwifery continuity models have clinical midwives at NG6 level providing caseload care. NG5 midwives also need opportunities to work in these models, in an effective framework of mentoring, professional support and guidance with clinical decision making. Models with options for both NG5 and NG6 midwives to work together are more sustainable as there are embedded succession plans within the model. The example given below is for a model that is additional to any current service. There is no redistribution of resources in this example however it is quite feasible to introduce this model of care through a redistribution of staff, clients and resources as indicated in Table 2 below. Costs outlined may vary locally however this provides a reasonable estimate. Table 1. Estimate example costs for initiating MGP model Labour costs (in line with current EB7 rates) Non labour Recurrent Non Labour Non Recurrent 6.0 FTE Midwives Grade 6 – 04 $ 809 768 Annualised salary with 30% loading as per EB7. (employee exp+SSP) 1.0 FTE Project Office Grade 7 – 03 6 mths (employee exp NG7-03 +SSP) $ 60 790 0.5 FTE A03 – 03 (employee exp+SSP) $ 35 726 Mobile Phone / pager Computer costs / remote access $ 3 000 Printer costs $ 549 Stationary costs Admin costs Car lease /reimbursement motor vehicle Clinical supplies Clinical equipment (1 set per midwife): Doppler $ 1 000 Scales $ 400 Ophthalmoscope $ 800 Otoscope $ 800 Stethoscope $ 250 Sphygmomanometer $ 200 Practice bag $ 400 Emergency birth kit $ 700 Breast pump and attachments $ 500 Computers $ 6 102 Office furniture and equipment $ 6 220 Client educational equipment · AN education and class or groups information and equipment Educational DVDs · Reference Library $ 3 000 $ 3 600 $ 2 000 $ 935 805 44 Delivering continuity of midwifery care to Queensland women
For private motor vehicle usage refer: • Policy reimbursement for motor vehicle usage www.health.qld.gov.au/qhpolicy/docs/ pol/qh-pol-149.pdf http://qheps.health.qld.gov.au/policy/docs/pol/qh-pol-271.pdf • Midwives should seek individual tax advice as they may choose to claim their private motor vehicle use as a work related tax deduction on their personal tax return rather than be reimbursed through the pay system. Business planning Once the vision for the maternity service and model has been determined, the Business Planning Framework (BPF)—tool for workload Management 2008 (Queensland Health 2008a) will guide development of the relevant service business or operational plan www.health. qld.gov.au/ocno/documents/BPF.pdf It may be useful to collaborate with an established comparable midwifery model and review their BPF. Matching supply of midwifery resources to a service is an integral part of a business plan. Developing a clear and complete outline in planning for the service and following the BPF principles will provide longevity and limit the need for repetitive business cases as the service grows. An example of a business case is in the appendix of the BPF tool. The Queensland Health BPF tool is a comprehensive reference and education resource which will assist in determining human resource requirements in the context of the demands placed on the service. This process should result in effective management of midwifery resources and workloads within a service. This approach to workload management focuses on balancing demand and supply of resources to meet the identified demand. Service Demand = meeting woman’s needs by considering factors such as: • acuity • activity • targets • layout and work environments • supply • service quality • consumer and staff safety • model of service delivery • financial outcomes • initiatives & policy direction and directives • public/private interface. Each stage of the process should not be considered in isolation or as separate from the desired outcome of developing a business/operational plan. The principles of the framework can be applied to a variety of health care services in rural, remote, tertiary, regional and community settings where midwives are employed by Queensland Health. Therefore the business plan will identify specific needs of a service and assist to determine issues such as: • if one FTE midwife can carry a workload of 40 women per year or if the profile of the service identifies this caseload should be reduced • upskilling requirements of midwives • orientation period to the model. Lobbying with partners and stakeholders for changes proposed within the business plan may be essential to gain support. Ensuring key Queensland Health target areas are being addressed and the proposal aligns to best practice quantitative and qualitative evidence makes for a strong business plan and provides measurable indicators that can be matched for evaluation of the service. For example ‘one-to-one’ midwifery care in labour (Queensland Health 2011). The framework is depicted in the diagram below. A guide to implementation 45
Page 1 and 2: Nursing and Midwifery Office, Queen
Page 3: Nursing and Midwifery Office, Queen
Page 6 and 7: Section 9 Professional development
Page 8 and 9: 4 Delivering continuity of midwifer
Page 10 and 11: 5. Cultural change—building a sup
Page 12 and 13: Section 1 Why provide continuity of
Page 14 and 15: These reforms can be seen as part o
Page 16 and 17: The emotional and social benefits w
Page 18 and 19: Section 2 Midwifery continuity mode
Page 20 and 21: shifts, but also rotate across ante
Page 22 and 23: For well women, evidence supports t
Page 24 and 25: Gottvall, K., Waldenstrom, U., Ting
Page 26 and 27: • The project officer develops se
Page 28 and 29: - on-call arrangements - relief - (
Page 30 and 31: Section 4 Key elements to successfu
Page 32 and 33: Key issues for leaders in midwifery
Page 34 and 35: At the Gold Coast Hospital Birth Ce
Page 36 and 37: Goondiwindi A review of Goondiwindi
Page 38 and 39: Culture of birth—current issues I
Page 40 and 41: A mechanism to inform and engage th
Page 42 and 43: Section 6 Clinical governance Eleme
Page 44 and 45: Consumer participation and informed
Page 46 and 47: Clinical practice guidelines To ens
Page 50 and 51: Balance of service demand and resou
Page 52 and 53: Considerations when implementing ca
Page 54 and 55: Section 8 Industrial issues The ann
Page 56 and 57: Example: A new MGP model is impleme
Page 58 and 59: References Collins, C., Fereday, J.
Page 60 and 61: Each midwife working in Queensland
Page 62 and 63: Midwives working in continuity of c
Page 64 and 65: Skills for managers Managers suppor
Page 66 and 67: • Midwifery Practice Review (MPR)
Page 68 and 69: • Find a few sources of evidence
Page 70 and 71: Interactions within the whole MGP T
Page 72 and 73: Measurement of continuity provided
Page 74 and 75: • clearly outline what constitute
Page 76 and 77: At 1 pm I receive a call from K, sh
Page 78 and 79: Section 11 Collaborative maternity
Page 80 and 81: Example Mary presents to Miles Hosp
Page 82 and 83: Collaboration with GPs A range of m
Page 84 and 85: How to sustain your model The abili
Page 86 and 87: References Homer, C. Brodie, P. & L
Page 88 and 89: MBS rebates are available for a ran
Page 90 and 91: Hybrid private and public models Wo
Page 92 and 93: operationalised the universal postn
Page 94 and 95: Glossary This glossary includes all
Page 96 and 97: Team midwifery: A model of maternit
Page 98 and 99:
94 Department of Health and Ageing.
Page 100 and 101:
Queensland Health. (2008b). Queensl
Page 102 and 103:
Acknowledgments Queensland Health w
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Delivering continuity of midwifery care to Queensland women

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