Promoting safety and role clarity among health professionals on Canada's First Alongside Midwifery Unit (AMU): A mixed-methods evaluation

Abstract

ObjectiveGlobally, midwife-led units are associated with improved clinical outcomes and childbirth satisfaction, but little is known about the impact of the model on health professionals themselves and interprofessional collaboration. The aim of this research was to describe the experiences of health professionals providing care in Canada's first Alongside Midwifery Unit. DesignA mixed-methods evaluation exploring healthcare provider's experiences using an online survey and qualitative semi-structured interviews and focus groups. SettingCanada's first Alongside Midwifery Unit, opened at X in 2018. In the Ontario context, the model reorganizes the way in which midwifery services are integrated in the hospital. ParticipantsMidwives, obstetricians, nurses, pediatricians, anesthetists, and other healthcare providers participated. Measurements & findings82 online surveys, 17 semi-structured interviews and one focus group were completed. Providers agreed that they perceived the Alongside Midwifery Unit was a success (89%) and perceived satisfaction among those receiving care on the unit(93%). The majority of providers were satisfied working on the unit (82%) and reported greater role clarity in the new model (85%) compared to the traditional model of midwifery services. Four main themes emerged from the health professionals' perspectives regarding how the unit impacted care: promoting safety, clarifying roles, facilitating collaboration, and managing change. Implications for practiceOverall, healthcare professionals had positive experiences working on the AMU, including improved role clarity and interprofessional relationships, and they perceived high levels of satisfaction among those giving birth on the unit. Our findings indicate the Alongside Midwifery Unit model can be beneficial for health professionals, women and birthing people.