O80 - Translating midwifery continuity of care models in regional NSW: Women and maternity staff experiences of implementing a new service

Abstract

Midwifery Continuity of Care (MCC) models significantly improve outcomes for women and their babies. Despite this widespread implementation of MCC has not been achieved, particularly in regional areas. This project evaluated the implementation of MCC across two regional/rural communities. The aim of this research was to understand the impact of the implementation process over the first 12 months of a new MCC service, across two regional NSW sites. A Realist evaluation was used to assess MCC within the structure of existing maternity services, accounting for both women and healthcare staff experiences of this change, exploring; what works, what doesn’t and why. Qualitative data was collected using a Claims, Concerns and Issues Framework to guide focus group interviews, across the two regional sites. Thematic and comparative data analysis was used and informed a Knowledge to Action Cycle to effect model improvements. Common themes across both participant groups identified that a ‘Trusting Relationship’ was highly valued, a need to review ‘Operational Issues’ and scaling up of ‘model to include all risk’. Thirdly, participants provided feedback on ‘Communication’ between stakeholders and identified opportunity for improvements of the model and implications for future implementation of MCC models The findings draw attention to concerns that women and health workforce face when transitioning into MCC models. Participants provided feedback on a number of issues, particularly communication surrounding the implementation of MCC. These findings informed service modifications and will support future translation of MCC in regional areas. Implications Implementation of MCC needs to be evaluated and a robust feedback loop using realist approach can provide valuable information to improve the implementation and design of MCC models; ensuring they meet the needs of rural and regional workforce, women and their communities.