Redesigning antenatal care: Prospective use of an implementation framework to establish a population‐based multidisciplinary first‐trimester screening, assessment and prevention service.
Background: Australian rates of adverse obstetric outcomes have improved little despite guidelines recommending history‐based screening and intervention. The first trimester provides a unique opportunity to predict and prevent complications, yet population‐based screening has failed to be translated...
| Publicado en: | Australian & New Zealand Journal of Obstetrics & Gynaecology Vol. 64; no. 6; pp. 588 - 596 |
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| Autores principales: | , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=181948880&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 181948880 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00048666 Q4M jtl: Australian & New Zealand Journal of Obstetrics & Gynaecology issn: 00048666 maglogo: Y pubinfo: dt: Dec2024 vid: 64 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 181948880 177390212 181948880 181948880 10.1111/ajo.13837 181948880 ppf: 588 ppct: 8 formats: tig: atl: Redesigning antenatal care: Prospective use of an implementation framework to establish a population‐based multidisciplinary first‐trimester screening, assessment and prevention service. aug: au: Borbolla Foster, Ailsa Haxton, Jennifer Bennett, Nicole Hyett, Jon Park, Felicity affil: Department of Maternity and Gynaecology, John Hunter Hospital, New Lambton Hts New South Wales,, Australia sug: subj: Maternal Health Services Australia Prenatal Care Medical Practice, Evidence-Based Quality of Health Care Quality Improvement Pregnancy Trimester, First Pregnancy, High Risk Pregnancy Complications Prevention and Control Health Screening Human Australia Female Pregnancy Prenatal Diagnosis Public Health Australia Patient Education Patient Centered Care Environmental Sustainability Questionnaires Funding Source Pre-Eclampsia Prevention and Control Implementation Science Health Services Accessibility Work Redesign Female ab: Background: Australian rates of adverse obstetric outcomes have improved little despite guidelines recommending history‐based screening and intervention. The first trimester provides a unique opportunity to predict and prevent complications, yet population‐based screening has failed to be translated into broad clinical practice. Aims: This study aimed to redesign antenatal care within an Australian public healthcare centre to align with evidence‐based maternity care, including population‐based first‐trimester screening with early initiation of preventative strategies in high‐risk pregnancies. Methods: A five‐phase action‐process model, sharing key elements with implementation science theory, was used to explore barriers to change in antenatal care, co‐design a novel service with consumers and establish a population‐based antenatal pathway commencing with a multidisciplinary first‐trimester screening, assessment and planning visit. Results: The case for change and associated barriers were defined from the perspective of antenatal care stakeholders. Key needs of each group were established, and solutions were created using co‐design methodology, allowing the team to create a novel approach to antenatal care which directly addressed identified barriers. Implementation of the service was associated with a fall in the median gestation at first specialist maternity care provider visit from 20 to 13 weeks. Conclusions: This study confirms the feasibility of establishing a comprehensive first‐trimester screening program within a public Australian healthcare setting and highlights a co‐design process which places individualised assessment at the forefront of antenatal care. This framework may be applicable to most public maternity settings in Australia, with expansion aimed at providing equity of care, including in rural and remote settings. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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