School of Nursing and Midwifery Western Sydney University, Locked Bag 1797 Penrith NSW 2751 Australia.
School of Business Western Sydney University, Locked Bag 1797 Penrith NSW 2751 Australia.
Women Birth. 2022 Mar;35(2):172-183. doi: 10.1016/j.wombi.2021.05.002. Epub 2021 May 26.
Although there is high-level evidence supporting positive perinatal outcomes for midwifery group practice (MGP) care, not all women can access this model due to a failure to implement or sustain it. The way that MGPs are managed could be an important factor in whether they are successful in the long-term.
To explore what determines optimal management of MGP in Australia, and the influence it has on sustainability of MGP.
Interviews were conducted with MGP midwives (n=8). Transcriptions of the audio recordings were analysed thematically and lexically for triangulation.
Following a thematic analysis of the data, an over-arching theme emerged - namely - being valued and supported, with three sub-themes: a nice little sweet spot, someone to stand up for you, and building relationships and support beyond the model. This revealed that value and support by all stakeholders, including the midwives themselves, was necessary to sustain an MGP. The lexical analysis revealed the themes: support, the system, and the caseload. This analysis highlighted the importance of the system - specifically, the impact of the institution on how MGP is operationalised.
For MGP to be sustained in Australia, it needs to be prioritised, nurtured, and embraced by the whole maternity care system. Management plays an important role in ensuring the right people are employed to pivotal positions and that midwifery-led models of care are valued and supported throughout the system.
尽管有高水平的证据支持助产小组实践（MGP）护理的围产期结局良好，但由于未能实施或维持这种模式，并非所有妇女都能获得这种模式。MGPs 的管理方式可能是其长期成功的一个重要因素。
探讨在澳大利亚，决定 MGP 最佳管理的因素是什么，以及它对 MGP 的可持续性有何影响。
对 8 名 MGP 助产士进行了访谈。对音频记录的文字进行了主题和词汇分析，以进行三角剖分。
对数据进行主题分析后，出现了一个总体主题，即被重视和支持，包括三个子主题：一个不错的小甜蜜点、有人为你挺身而出、建立超越模式的关系和支持。这表明，包括助产士自身在内的所有利益相关者的价值和支持对于维持 MGP 是必要的。词汇分析揭示了支持、系统和病例量这三个主题。这一分析强调了系统的重要性，特别是机构对 MGP 运作方式的影响。
要使 MGP 在澳大利亚得以维持，整个孕产妇保健系统都需要优先重视、培育和接受它。管理在确保将合适的人员安排到关键职位，并在整个系统中重视和支持以助产士为主导的护理模式方面发挥着重要作用。
