Delivering continuity of midwifery care to Queensland women

Contents
List of appendices.......................................................................................................................3
Executive summary.....................................................................................................................5
Section 1 Why provide continuity of midwifery care ..................................................................8
The purpose of this guide ........................................................................................................................ 8
Why provide midwifery continuity of care................................................................................................. 8
Section 2 Midwifery continuity models —what do they look like..............................................14
Definitions ............................................................................................................................................. 14
What is a midwifery continuity model..................................................................................................... 15
Midwifery group practice......................................................................................................................... 16
Who receives midwifery continuity of care.............................................................................................. 16
Place of care............................................................................................................................................ 17
Section 3 How to implement a new model................................................................................21
Phase 1—Preparation.............................................................................................................................. 21
Phase 2—Commencing the project.......................................................................................................... 21
Phase 3—Pre–implementation................................................................................................................ 23
Phase 4—Implementation....................................................................................................................... 25
Section 4 Key elements to successfully implementing a midwifery continuity of care model......26
A woman-centred philosophy of care....................................................................................................... 26
Vision ..................................................................................................................................................... 27
Leadership ............................................................................................................................................. 27
Communication ..................................................................................................................................... 28
Engagement of stakeholders................................................................................................................... 30
Section 5 Cultural change—shared vision: shared culture..........................................................33
Moving from traditional models to midwifery continuity........................................................................... 33
Culture of birth—current issues................................................................................................................ 34
Steps in changing culture........................................................................................................................ 34
Section 6 Clinical governance ..................................................................................................38
Overview................................................................................................................................................. 38
Risk management.................................................................................................................................... 38
Monitoring and review............................................................................................................................. 39
Consumer participation and informed choice........................................................................................... 40
Clinical audit........................................................................................................................................... 40
Key Performance Indicators .................................................................................................................... 41
Professional development....................................................................................................................... 41
Credentialing.......................................................................................................................................... 41
Research and development..................................................................................................................... 41
Complaints management......................................................................................................................... 41
Evidence-based practice.......................................................................................................................... 41
Clinical practice guidelines...................................................................................................................... 42
Section 7 Costing and revenue for caseload models..................................................................43
Establishment costs................................................................................................................................ 43
Input costs.............................................................................................................................................. 43
Business planning................................................................................................................................... 45
Costing.................................................................................................................................................... 46
Considerations when implementing caseload (group practice) model...................................................... 48
Revenue for caseload (Group Practice) based on six FTE midwives—240 births per year........................... 48
Section 8 Industrial issues .......................................................................................................50
The annualised salary............................................................................................................................. 50
A guide to implementation
1