Collaboration in maternity care: a randomised controlled trial comparing community-based continuity of care with standard hospital care

Homer, Caroline; Davis, Gregory K.; Brodie, Pat; Sheehan, Athena; Barclay, Lesley; Wills, Jo; Chapman, Michael

doi:10.1016/s0306-5456(00)00022-x

Cited by 50 publications

(57 citation statements)

References 14 publications

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“…Women who had a midwife-led care model were less likely to experience hospitalisation (risk ratio (RR) 0.90, 95% confidence interval (CI) 0.81 to 0.99), the use of local analgesia (RR 0.81, 95% CI 0.73 to 0.91), episiotomy (RR 0.82, 95% CI 0.77 to 0.88), instrumental delivery (RR 0.86, 95% CI 0.78 to 0.96) and were likely to experience no intrapartum analgesia/anaesthesia (RR [45]. Homer et al [46] tested whether a new community-based model COC provided by midwives and obstetricians improved maternal clinical outcomes, in particular by reducing the caesarean section rate. The findings demonstrated a significant difference in the caesarean rate between the community group and the control group.…”

Section: Patients' Perspective On Lack Of Trust and Involvement As Wmentioning

confidence: 99%

Patient Safety, Adverse Healthcare Events and Near-Misses in Obstetric Care —A Systematic Literature Review

Severinsson¹,

Haruna²,

Rönnerhag³

et al. 2015

OJN

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Systematic development of a patient safety culture is necessary because lack of quality care leads to human suffering. The aim of this review was to identify evidence of obstetric adverse events (AEs) and near-misses in the context of patient safety. We conducted a search of the published literature from Europe, Australia and the USA in the following databases: Cinahl, Cochrane, Maternity and Infant Care, Ovid, Pro-quest and PubMed, guided by PRISMA procedures. A total of 427 studies were screened, 15 full papers retrieved and nine studies included in the final thematic analysis. The selected papers address a broad spectrum of adverse patient safety events in obstetric care. The themes that emerged were: type of AEs, near-misses and their consequences, strategies to support and improve Patient Safety (PS) and domains related to the WHO Patient Safety competence outcomes. The findings of the first theme were grouped into the following categories: healthcare professionals' perspectives on ethical conflicts, attributing blame and responsibility, and patients' perspectives on lack of trust and involvement, as well as medication errors. The second theme, strategies to support interventions to improve PS, was based on two sub-themes: communicating effectively and gaining competence by learning from adverse events, while the third theme was domains related to the WHO Patient Safety competence outcomes. In conclusion, few studies have examined strategies for managing AEs despite the existence of programmes that target the implementation of changes, such as improved teamwork training. In addition to exploring strategies to make safety a priority for patients and healthcare professionals, it is of the utmost importance to improve communication with patients and between professionals in order to maintain and enhance safety. Efforts by organizations and individuals to continuously develop knowledge * Corresponding author. E. Severinsson et al.1111 about the risk of AEs and the use of best practice guidelines are also essential.

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Section: Patients' Perspective On Lack Of Trust and Involvement As Wmentioning

confidence: 99%

Patient Safety, Adverse Healthcare Events and Near-Misses in Obstetric Care —A Systematic Literature Review

Severinsson¹,

Haruna²,

Rönnerhag³

et al. 2015

OJN

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“…The sample size was calculated using the primary clinical outcome measure in the main trial, that is, caesarean section rate (Homer et al 2001a). At a significance level of 0.05 with 80% power, a sample of 1000 women was required to detect a fifty per cent reduction in the caesarean section rate.…”

Section: Sample Sizementioning

confidence: 99%

“…The STOMP model was established within the existing budget of a metropolitan teaching hospital and evaluated in a randomised controlled trial. The clinical outcomes, antenatal experiences of women and costs are reported elsewhere (Homer et al 2000;Homer et al 2001b;Homer et al 2001a). An important outcome measure in the trial was the experience of women as measured in the postnatal period.…”

Section: Introductionmentioning

confidence: 99%

Women's experiences of continuity of midwifery care in a randomised controlled trial in Australia

Homer¹,

Davis²,

Cooke

et al. 2002

Midwifery

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Objective: To compare the experiences of women who received a new model of continuity of midwifery care with those who received standard hospital care during pregnancy, labour, birth and the postnatal period.Design: A randomised controlled trial was conducted. One thousand and eighty-nine women were randomly allocated to either the new model of care, the St George Outreach Maternity Project (STOMP), or standard care. Women completed a postal questionnaire 8-10 weeks after the birth.Participants: Women in the trial were of mixed obstetric risk status and more than half the sample were born in a non-English speaking country.Results: Questionnaires were returned from 69 per cent of consenting women. STOMP women were significantly more likely to have talked with their midwives and doctors about their personal preferences for childbirth and more likely to report that they knew enough about aspects of labour and birth, particularly induction of labour, pain relief and caesarean section. Almost 80 per cent of women in the STOMP group experienced continuity of care, that is, one of their team midwives was present, during labour and birth. STOMP women reported a significantly higher 'sense of control during labour and birth'. Sixty three per cent of STOMP women reported that they 'knew' the midwife who cared for them during labour compared with 21 per cent of control women. In a secondary analysis, women who had a midwife during labour who they felt that they knew, had a significantly higher sense of 'control' and a more positive birth experience compared with women who reported an unknown midwife.Postnatal care elicited the greatest number of negative comments from women in both the STOMP and the control group. Conclusion:The reorganisation of maternity services to enable women to receive continuity of care has benefits for women. The benefits of a known labour midwife needs further research.

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“…One of the key areas of concern in the Healthcare Commission's review of maternity services (2008) was that there was not adequate continuity of care for women. Caseload midwifery has been introduced in a number of units in the UK and in other countries with integrated midwifery services with favourable results, including increased continuity, a reduction in intervention in labour and increased satisfaction for women , Benjamin et al 2001, Homer et al 2001, Homer et al 2002, McCourt et al 1998, North Staffordshire 2000, Sandall et al 2001. These findings echo those of wider studies of continuity in health care (Haggerty et al 2003, Nutting et al 2003 Despite positive findings, the introduction of caseload practice has not been widespread, although there is little research to suggest why this may be.…”

Section: Introductionmentioning

confidence: 99%

Caseload midwifery in a multi-ethnic community: The women's experiences

et al. 2013

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Objective: To evaluate caseload midwifery in a relatively deprived and ethnically diverse inner-city area.Design and setting: Semi-structured interviews were undertaken with 24 women from diverse ethnic backgrounds, 12 of whom had received caseload care and 12 women from an adjacent area who had received conventional maternity care in a large inner-city maternity unit. Framework analysis was adopted drawing on links with the authors' previous work on women's views of caseload midwifery. Key conclusions and implications:Women from this socially and ethnically diverse group of women had similar views and wanted similar care to those in previous studies of caseload midwifery. Many of the women receiving caseload care highlighted the close relationship they had with the midwives and as a result of this 2 felt more able to discuss their concerns with them. This has the potential not only for improved quality of care but also improved safety.

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Collaboration in maternity care: a randomised controlled trial comparing community-based continuity of care with standard hospital care

Cited by 50 publications

References 14 publications

Patient Safety, Adverse Healthcare Events and Near-Misses in Obstetric Care —A Systematic Literature Review

Patient Safety, Adverse Healthcare Events and Near-Misses in Obstetric Care —A Systematic Literature Review

Women's experiences of continuity of midwifery care in a randomised controlled trial in Australia

Caseload midwifery in a multi-ethnic community: The women's experiences

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