Implementing continuity of carer pathway for low risk pregnant women

Quality Improvement Poster Download

Background & Problem

Throughout the Stroud Area women who choose to give birth in the freestanding birth unit or at home are usually cared for by a midwife that has not previously been known to them. In the current system, intrapartum care is provided by the core midwife on the shift with community support at the time of birth. Women choosing home birth are cared for by the designated-on call community midwife, however some community midwives chose to be available for some of their women to provide continuity.

We chose to focus our project on the birth unit and Stroud community teams. The birth unit was staffed by core midwives and the community by two teams currently called RED and BLUE teams.

We chose to focus on the women on our caseloads that chose to give birth at either the birth unit or home. This is currently 370 women per year (2018).

Aim

All women who choose Stroud or home as their place of birth will be cared for by a midwife known to them. The better birth guidance is 20% of women should be booked on to a continuity of carer pathway by March 2019.

Method

As part of our PDSA cycle we are currently due to launch our Quality Improvement in June 2019.

We planned our project by gaining information from the following actions:

• Staff focus groups
• Staff Ballot
• Attending Better Birth conferences and local maternity system sessions
• Visits to other similar freestanding birth unit and a pop-up birth centre in the Wirral.
• Launch workshops for staff to look at new rotas and teams.
• Attended King’s College continuity workshops.
• Meetings with Better Births Lead and Meetings with senior management team.
• Business plan for senior managers and full costing s for increased equipment requirements.

Results

An Integrated continuity of carer model to be launched in June 2019. Initial Launch was March 2019 but delayed due to final decisions around level of staffing required. New band 5 development midwife recruited in May 2019 for one year.

Implications

Prior to commencing a project you need to ensure that all stakeholders are in agreement to fund requests for increased cost implications for the trust and the long term sustainability of this funding.