Collaboration for Maternal and Newborn Health

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• Collaboration for Maternal and Newborn Health
• Sue Harris
• Lehe Elarar
• March 1st, 2007 In-BC Workshop

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Collaboration for Maternal and Newborn Health
(CMNH) In-BC Projects

• The Collaboration for Maternal Newborn Health
  (CMNH) is an initiative designed to increase
  communication and interdisciplinary practice
  between all maternity care providers. The members
  of the Steering and Advisory committees include
  family physicians, obstetricians, nurses,
  midwives, researchers and doulas. We work as a
  team to develop an integrated approach to
  maternity care education, research, advocacy,
  policy, and sustainability.

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Overview CMNH

• Currently six projects underway
• Doula Support Program
• Interprofessional Intrapartum Workshop
• Evaluation of an Interprofessional Clerkship
• Electronic Postpartum Hemorrhage Training Module
• Interprofessional Breastfeeding and Infant Sleep
  Workshop
• Interprofessional Rural Forum

Team includes
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Doula Support Program

• Student Led program
• Weekly meetings with a facilitator (Doula
  educator)
• Curriculum design led by students
• Doula training for an interprofessional group of
  students
• Nursing, Midwifery, Medicine
• Free doula support through labour and birth for
  women with substance misuse ( Fir Square at BC
  Womens)
• Groups of three (one from each discipline)
  connect with a woman, follow her through her
  pregnancy
• On-call student from the team attends the birth
• Future Goal
• Participatory research with women
• Permanent support for the program

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Students Speak

• This project has been a phenomenal enrichment to
  my first year of midwifery. The opportunity to
  develop interdisciplinary relationships has been
  extremely beneficial, and I feel that each of us
  will practice more respectfully and more
  cohesively as part of a team, as a result of this
  project.
• Midwifery Student
• We are the future of health care and will use
  this experience to build positive
  interprofessional teamwork for years to come.
• Nursing Student
• We gain experience in holistic and
  non-judgmental maternity care that will make us
  better caregivers, no matter which discipline we
  choose for our practice in the future.
• Medical Student

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Interprofessional Intrapartum Workshop

• Students come together to learn and interact in
  an interprofessional setting about normal birth
• Medical, Nursing and Midwifery students
  participate in the workshop
• The facilitators are an interprofessional group
• Family Physicians, Obstetricians, Midwives,
  Nurses, Childbirth Educators, Doulas
• Students participate in lectures and hands-on
  stations

• Online module developed to bring workshop to
  distant sites
• Prince George
• Victoria
• Future Goal
• Introduce workshop to all students

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Students Speak
.

• What I liked about most about this workshop was
  the mix of health care professionals in the
  workshop that demonstrated the importance of an
  interdisciplinary approach.
• Medical student
• What I liked most about the workshop was
  learning about birthing and labour in a friendly,
  positive and informative environment
• Midwifery student
• The delivery workshop was great at getting the
  right feel of a delivery! The Leopolds maneuvers
  and vaginal exam stations were also excellent! It
  was very helpful to have the opportunity to
  practice these skills on a model with other
  students and with the facilitators.
• Medical student

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Evaluation of an Interprofessional Clerkship

• Students surveyed during their clerkship to
  evaluate if their experience influences their
  decision to practice maternity care
• Data collected from several universities across
  Canada
• Analysis of data and recommendations planned

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Electronic Postpartum Hemorrhage Module

• On line module aimed at interprofessional
  maternity care providers
• Management of postpartum hemorrhage (PPH)
• Case-based module for self instruction
• Goal To improve management of PPH across the
  province
• Future Goal
• Development of other modules for the
• management of maternity care

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Electronic Postpartum Hemorrhage Module
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Electronic Postpartum Hemorrhage Module
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Interprofessional Breastfeeding and Infant Sleep
Workshop

• Workshop for students from different disciplines
  
• Midwifery, Nursing Medical students
  participated
• Evaluation of their knowledge and conceptions on
  nursing and infant sleep
• On-line module designed to train educators about
  breastfeeding and sleep issues
• Emphasis is placed on how an interprofessional
  team can support parents
• Future Goal
• Increase education for
• students

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Interprofessional Breastfeeding and Infant Sleep
Workshop
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Interprofessional Rural Forum

• Community Event to offer voice to women, provider
  education, introduction of students to
  interprofessional rural care
• The Sea-to-Sky Corridor was selected as the site
  for the forum
• Lack of maternity care options for women and
  families
• Women traveling distances for care
• Midwifery, Nursing and Medical Students
• Travel and accommodation together
• Education with community providers
• Attendance at forum and workshops
• Community involvement
• Health practitioners, health administrators, and
  community members

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Interprofessional Rural Forum

• The Forum
• Barriers discussed
• Opportunity to address important concerns
• The Skills Updates Workshop
• Interprofessional setting
• Opportunity to collaborate
• Evaluation
• Positive feedback
• Number of attendants
• 14 community members, including local
  practitioners
• 12 students (4 nursing, 4 medical, 4 midwifery)
• Future Goal
• Offer forum to other rural communities

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Students Speak

• The rural forum made me more excited about a
  future in maternity care and gave me a clearer
  picture of what maternal health is like in a
  rural setting.
• Nursing Student
• The forum really helped me understand the issues
  at the heart of pregnant women and their families
  and the limitations to provision of services in
  remote/rural areas.
• Medical Student
• I would consider practicing rural maternity care
  because I like the idea of feeling part of a
  tight-knit community and collaborating with other
  health care practitioners in a supportive model.
  Keeping care close to home seems important for a
  community to live as a whole.
• Midwifery Student

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IPE indicators

• Doula students recognize the value of
  decision-making within a team for the improved
  care of the women on Fir Square
• Students participating in the Interprofessional
  Intrapartum Workshop appreciate learning about
  other maternity health disciplines and report
  that this helps them understand how an
  interprofessional team can work together
• Participants in the Rural Forum and Skills
  Updates Workshop were highly satisfied with the
  opportunity to interact in an interprofessional
  setting

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Collaborative Practice

• Facilitators in the Intrapartum Workshop
  demonstrate the values of collaborative practice
  by illustrating the role of each health
  profession during pregnancy, birth and postpartum
• An interprofessional team of maternity care
  providers collaborate and share ideas to create a
  module that will train educators and
  practitioners to a team approach in the
  management of postpartum hemorrhage
• Students participating in the Breastfeeding and
  Infant Sleep Workshop express an enhancement of
  tools and methods to communicate with postpartum
  patients

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Patient-Centred Care

• Doula students describe that a holistic approach
  to caring for women on Fir Square is essential
  and made possible by working in an
  interprofessional team
• One of the goals of the Interprofessional
  Intrapartum Workshop is to promote an approach
  that empowers women
• Students participating in the Breastfeeding and
  Infant Sleep Workshop understand that
  patient-centered care is directly enhanced by a
  unified team of interprofessional care providers.
  

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Lessons Learned

• By keeping education patient-centered,
  interdisciplinary students can learn issues for
  all team members in order to provide optimal
  team-based care.
• These project formats, such as the rural forum,
  are an introduction to other environments, other
  collaborative models and other practice settings.
• At the undergraduate level, this may provide the
  first opportunity to model collaborative decision
  making and team work skills. These projects
  introduce models of interprofessional
  collaboration that can be integrated in actual
  practice.
• This type of education requires time and energy
  in order to develop the curriculum. The
  educators/providers need to be willing to give up
  preconceived ideas or entrenched positions.
• Opportunities for interdisciplinary teaching and
  learning can enhance the experience of both
  teachers and learners.

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Sustainability

• Online modules increase access to
  interprofessional resources
• Students who learn in an interprofessional
  setting are highly satisfied and some indicate a
  commitment to maternity care for the future
  capacity building
• Reports, publications, presentations help
  disseminate the knowledge gained
• Funding sought for and established to promote
  ongoing workshops e.g.Doula Project,
  Breastfeeding and Sleep Workshop and Intrapartum
  Workshop
• Alignment with other national, provincial, local
  initiatives MCP2, UBC Trek 2010, BCRCP