Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE (Open Access)

An empirical investigation into beliefs about collaborative practice among maternity care providers

Bernadette M. Watson A D , Michelle L. Heatley B , Sue G. Kruske B and Cindy Gallois C
+ Author Affiliations
- Author Affiliations

A School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia.

B School of Psychology, Queensland Centre for Mothers and Babies, The University of Queensland, Brisbane, QLD, Australia. Email: m.heatley@uq.edu.au; Sue.Kruske@uq.edu.au

C Faculty of Social and Behavioural Sciences, The University of Queensland, St Lucia, Qld 4072, Australia. Email: c.gallois@uq.edu.au

D Corresponding author. Email: bernadette@uq.edu.au

Australian Health Review 36(4) 466-470 https://doi.org/10.1071/AH11104
Submitted: 27 October 2011  Accepted: 15 March 2012   Published: 10 September 2012

Journal Compilation © AHHA 2012

Abstract

Objective. To investigate agreement with the National Health and Medical Research Council (NHMRC) definition of collaboration in maternity care by care providers, and to examine their preferences for models of care in order to shed light on the lack of success in implementing collaborative practice.

Methods. Maternity care providers completed a survey in Queensland. The final sample consisted of 337 participants, including 281 midwives (83.38%), 35 obstetricians (10.39%), and 21 general practitioners (6.23%).

Results. Ninety-one percent of the participants agreed with the NHMRC definition of collaboration: Midwives (M = 5.97, s.d. = 1.2) and doctors (obstetricians and general practitioners: M = 5.7, s.d. = 1.35) did not differ significantly in their level of agreement with definition (t (332) = –1.8, P = .068). However, 72% of doctors endorsed a doctor-led model of care, whereas only 6.8% of midwives indicated agreement with it. Fewer (56%) doctors agreed with the midwife-led model of care, whereas 99.3% of midwives endorsed it.

Conclusion. The concept of collaboration does not recognise the different interpretations by midwives and doctors of its impact on their roles and behaviours. Successful collaborative practice requires the development of guidelines that recognise these differences and specify the communication behaviour that would assist midwives and doctors to practice collaboratively.

What is known about the topic? Across all healthcare contexts effective communication is a critical part of good patient care. Effective communication refers to communication between care providers and patients but also between different interprofessional care providers. In the area of maternity care one aspect of effective communication between maternity care providers is collaborative care. This paper highlights why collaborative care and effective communication between maternity care providers is lacking. We demonstrate that the NHMRC guidelines are interpreted differently according to the different professional role of the maternity care provider.

What does this paper add? This paper empirically investigates the perceptions of maternity care providers. It shows that each maternity care profession has a different understanding about what collaboration means in practice. This paper acknowledges these different perceptions, which are usually not noted, and builds on this fact to improve effective communication and bring about collaborative care.

What are the implications for practitioners? In this paper, we highlight that while maternity care practitioners all aspire to collaborative care, their perceptions of what collaborative care actually means differs according to professional role. For practitioners to move forward they must develop guidelines that take account of the respective philosophies and levels of different expertise each maternity care profession brings to a woman’s care. The guidelines will assist obstetricians and midwives to recognise their unique and specific areas of expertise, each of which may be required at different times according to a woman’s medical needs. This new approach to interprofessional differences will bring about trust and respect and assist collaborative care.


References

[1]  Bosanquet N, Ferry J, Lees C, Thornton J. Maternity services in the NHS. Reform, 2005; Available from http://www.reform.co.uk/Research/Health/HealthArticles/tabid/80/smid/378/ArticleID/596/reftab/69/t/Maternity%20services%20in%20the%20NHS/Default.aspx [Verified 21 October 2009]

[2]  Multidisciplinary Collaborative Primary Maternity Care Project. Final Report. Multidisciplinary Collaborative Primary Maternity Care Project (MCP2); 2006. Available from: http://www.mcp2.ca/english/FinalReport-HealthCanada.asp. [Verified 4 November 2009]

[3]  Department of Health and Ageing. Improving Maternity Services in Australia: The Report of the Maternity Services Review. Canberra 2009; Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/msr-report. [Verified 17 August 2012]

[4]  Department of Health and Community Services. Maternity Services Review in the Northern Territory. 2007; Available from: http://health.nt.gov.au/Publications/Corporate_Publications/Maternity_Services_Model/index.aspx. [Verified 25 November 2009]

[5]  Department of Human Services. Future directions for Victoria’s maternity services. Melbourne Programs Branch; 2004. Available from: http://www.health.vic.gov.au/maternitycare/. [Verified 26 October 2009]

[6]  Hirst C. Re-birthing: Report of the review of maternity services in Queensland. Brisbane: Queensland Health. 2005; Available from: http://www.health.qld.gov.au/publications/corporate/. [Verified 1 July 2009]

[7]  Royal Australian and New Zealand College of Obstetricians and Gynaecology. Maternity Services Review 2008; Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/maternityservicesreview-214. [Verified 9 October 2009]

[8]  Australian College of Midwives. Maternity services review submission. [Submission] 2008; Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/maternityservicesreview-380. [Verified 9 October 2009]

[9]  Downe S, Finlayson K, Fleming A. Creating a collaborative culture in maternity care. J Midwifery Womens Health. 2010; 55 250–4.
| 20434085PubMed |

[10]  Reiger K, Lane K. Working together: collaboration between midwives and doctors in public hospitals. Aust Health Rev 2009; 33 315–24.
Working together: collaboration between midwives and doctors in public hospitals.Crossref | GoogleScholarGoogle Scholar | 19563323PubMed |

[11]  Ødegård A, Strype J. Perceptions of interprofessional collaboration within child mental health care in Norway. J Interprof Care 2009; 23 286–96.
Perceptions of interprofessional collaboration within child mental health care in Norway.Crossref | GoogleScholarGoogle Scholar | 19387908PubMed |

[12]  D’Amour D, Ferrada-Videla M, San Martin Rodriguez L, Beaulieu MD. The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks. J Interprof Care 2005; 19 116–31.
The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks.Crossref | GoogleScholarGoogle Scholar | 16096150PubMed |

[13]  Commonwealth of Australia. National Health (Collaborative arrangements for midwives) Determination 2010. Under subsection 84 (1) of the National Health Act 1953 . 2010; Available from: http://www.comlaw.gov.au/Details/F2010L02105. [Verified 17 August 2012]

[14]  Smith C, Brown JB, Stewart M, Trim K, Freeman T, Beckhoff C, et al Ontario care providers’ considerations regarding models of maternity care. J Obstet Gynaecol Can 2009; 31 401–8.
| 19604420PubMed |

[15]  Keleher KC. Collaborative practice: characteristics, barriers, benefits, and implications for midwifery. J Nurse Midwifery 1998; 43 8–11.
| 1:STN:280:DyaK1c7ltVGnsQ%3D%3D&md5=46e903bce0620fdd33f9cff2983289a3CAS | 9489285PubMed |

[16]  Klein MC, Kaczorowski J, Hall WH, Fraser W, Liston RM, Eftekhary S, et al The attitudes of Canadian maternity care practitioners towards labour and birth: many differences but important similarities. J Obstet Gynaecol Can 2009; 31 827–40.
| 19941707PubMed |

[17]  National Health and Medical Research Council. National Guidance on Collaborative Maternity Care. Canberra 2010; Available from: http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/CP124_maternity%20guideline.pdf. [Verified 17 August 2012]

[18]  Ødegård A. Perceptions of interprofessional collaboration in relation to children with mental health problems. A pilot study. J Interprof Care 2005; 19 347–57.
Perceptions of interprofessional collaboration in relation to children with mental health problems. A pilot study.Crossref | GoogleScholarGoogle Scholar | 16076596PubMed |

[19]  Aitken C, Power R, Dwyer R. A very low response rate in an on-line survey of medical practitioners. Aust N Z J Public Health 2008; 32 288–9.
A very low response rate in an on-line survey of medical practitioners.Crossref | GoogleScholarGoogle Scholar | 18578832PubMed |

[20]  VanGeest JB, Johnson TP, Welch VL. Methodologies for improving response rates in surveys of physicians: a systematic review. Eval Health Prof 2007; 30 303–21.
Methodologies for improving response rates in surveys of physicians: a systematic review.Crossref | GoogleScholarGoogle Scholar | 17986667PubMed |

[21]  SPSS for Windows. Rel. 17.0.1. Chicago: SPSS Inc.; 2008.

[22]  The Royal Australian College of General Practitioners. Response to Improving Maternity Services in Australia. 2008; Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/maternityservicesreview-459. [Verified 28 September 2012]

[23]  Leap N. Woman-centred or women-centred care: does it make a difference? B J Midwifery 2008; 16 736–41.

[24]  Siassakos D, Timmons C, Hogg F, Epee M, Marshall L, Draycott T. Evaluation of a strategy to improve undergraduate experience in obstetrics and gynaecology. Med Educ 2009; 43 669–73.
Evaluation of a strategy to improve undergraduate experience in obstetrics and gynaecology.Crossref | GoogleScholarGoogle Scholar | 19573190PubMed |

[25]  Pollard K. Student engagement in interprofessional working in practice placement settings. J Clin Nurs 2009; 18 2846–56.
Student engagement in interprofessional working in practice placement settings.Crossref | GoogleScholarGoogle Scholar | 19220612PubMed |

[26]  Wackerhausen S. Collaboration, professional identity and reflection across boundaries. J Interprof Care 2009; 23 455–73.
Collaboration, professional identity and reflection across boundaries.Crossref | GoogleScholarGoogle Scholar | 19657938PubMed |