Document Detail


Early labour services: Changes, triggers, monitoring and evaluation.
MedLine Citation:
PMID:  22840680     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: to identify the changes to early labour services, their triggers and monitoring. DESIGN AND SETTING: a mixed methods approach in two stages, firstly a postal questionnaire survey of Heads of Midwifery (HoM) services in NHS Trusts in England (cover sheet to each HoM and questionnaire for each unit in their jurisdiction) and, secondly, semi-structured telephone interviews with a purposive sample of senior midwives. The interviews sought further information about reasons for change; the impact of changes and explored the unit's particular innovations. PARTICIPANTS AND RESPONSE RATE: 145 (89%) NHS Trusts provided data (cover sheet and/or questionnaire); responses were received from all areas and types of unit. Seventeen HoMs or designated senior midwives were interviewed. FINDINGS: 83 of 170 units (49%) had made changes to early labour service provision during the past 5 years, including home assessment; the introduction of triage units and telephone assessment tools. Changes were more likely in high volume units and in consultant units with midwifery-led care areas. Further changes were planned by 93/178 (25%) units. Triggers for changes to early labour services comprised local or unit-based factors, including Category X (non-labour) admissions, response to service users and research evidence. The impact of Category X admissions on workload contributed to the triggers for change. Fifty-six (31%) could provide a confirmed figure or estimate for category X admissions. Experiences of introducing change included issues related to engagement of the workforce and the contribution of clinical leadership. Thirty-eight (48%) units did not routinely monitor use of early labour services. Overall monitoring of services was not significantly more likely in units that had made changes. Audit activity was reported more frequently in units that had made changes to their early labour services. CONCLUSIONS: early labour services had undergone significant changes following a range of triggers but the extent of change was not reflected in monitoring and evaluation activity. IMPLICATIONS FOR PRACTICE: Changes to service provision should be accompanied by monitoring and evaluation. Changes to services require utilisation of appropriate change management strategies.
Authors:
Helen Spiby; Josephine M Green; Helen Richardson-Foster; Clare Hucknall
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-26
Journal Detail:
Title:  Midwifery     Volume:  -     ISSN:  1532-3099     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510930     Medline TA:  Midwifery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
Affiliation:
School of Nursing, Midwifery and Physiotherapy, University of Nottingham, A Floor, Medical School, Queen's Medical Centre, Nottingham NG7 2HA, UK.
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