CMNH

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

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

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.

Overview CMNH: 

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:

Doula Support Program: 

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 Women’s) 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

Students Speak: 

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

Interprofessional Intrapartum Workshop: 

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

Students Speak: 

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 Leopold’s 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

Evaluation of an Interprofessional Clerkship: 

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

Electronic Postpartum Hemorrhage Module: 

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

Electronic Postpartum Hemorrhage Module: 

Electronic Postpartum Hemorrhage Module

Electronic Postpartum Hemorrhage Module: 

Electronic Postpartum Hemorrhage Module

Interprofessional Breastfeeding and Infant Sleep Workshop: 

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

Interprofessional Breastfeeding and Infant Sleep Workshop: 

Interprofessional Breastfeeding and Infant Sleep Workshop

Interprofessional Rural Forum: 

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

Interprofessional Rural Forum: 

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

Students Speak: 

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

IPE indicators : 

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

Collaborative Practice : 

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

Patient-Centred Care : 

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.

Lessons Learned: 

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.

Sustainability: 

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