Creating an ideal pregnancy journey

This virtual model of care provides another option for women to access care in pregnancy.

View a poster from the Centre for Healthcare Redesign graduation April 2022.

Aim

By June 2022, 20% of pregnant women who are registered in the Hastings Macleay Clinical Network antenatal service will have used the virtual model of care.

Benefits

Patients

• Improved access to antenatal services
• Increased ability for partners and support people to attend appointments
• Decreased time away from commitments, such as work and parenting

Staff

• Reduced influence of external delays, such as those due to traffic, parking, etc. on consultation time
• Facilitates patient-centred interactions between midwives, pregnant women and their partners and support people, where these might not otherwise be possible

Healthcare system

• Provides greater choice and options for pregnant women during COVID-19 restrictions and beyond
• During time of visitor restrictions, the antenatal outpatient waiting room could practice social distancing, due to a reduced number of in-person appointments for pregnant women

Background

Since 2019 Mid North Coast Local Health District Hastings Macleay Network antenatal face-to-face clinics have intermittently been suspended due to COVID-19, fires and flooding. These disasters physically isolated women from services and the hesitation to leave their home and families during these difficult situations. This impacted on when women accessed comprehensive care. Telephone was the only way to make contact with these women, which created a sense of disconnect from their midwife and doctor.

Implementation

Initiation

A service wasn’t being provided for women who were unable to attend face-to-face appointments due to COVID-19 lockdowns and natural disasters. The project team was established to address this gap.

Diagnostics

This phase included:

• Patient surveys
• Staff interviews
• Process mapping
• Engaging our steering committee
• Focus groups
• Data analysis
• Patient file audits
• Root cause analysis and prioritisation process

22 issues were identified. 8 issues were prioritised.

Method

The development of solutions included:

• Brainstorming for solutions with steering committee
• EAST (Easy, Timely Social and Timely) framework activity with senior leaders
• Literature review of current best practice

Solutions

• Train midwives to use the myVirtualCare platform
• Implement a five week trial whilst our state was in a lockdown
• Use myVirtualCare to book women in for their antenatal care

Implementation

The implementation was guided by the Accelerating Implementation Methodology strategy document.

• Test the virtual model of care
• Produce a guideline on virtual care in maternity services
• Educate antenatal staff to use the virtual care platform
• Communicate the new model of care
• Collate data

Status

Implementation – The project is ready for implementation or is currently being implemented, piloted or tested.

Dates

• 1 July 2021 Planning for trial
• 1 April 2022 Start of implementation

Implementation sites

• Port Macquarie Base Hospital
• Kempsey District Hospital

Partnerships

• Centre for Healthcare Redesign
• Werin Aboriginal Corporation Medical Centre

Results

The results of this project include the collection and evaluation of the following information.

• Surveys of women who had attended care via the virtual care platform.
  • 90% of women reported “about the same or better” than an in person visit.
  • 100% of women surveyed reported they could get an appointment time that suited them.
  • 100% of women surveyed reported the overall experience as “very good”
• Surveys of staff using the my virtual care platform
  • 95% of staff reported confidence in using the platform
  • 70% of staff trained in using my virtual care platform
• 80.3% of women have used the myVirtualCare platform to access antenatal care

Lessons learnt

• Fully assess the problem prior to reaching a solution.
• Be prepared to reach out for help beyond those that are on the steering committee
• Finding time with your steering committee during a global pandemic is very challenging.
• When asking your manager for the time to complete the project, you will need minimum two days a week. One day is not enough time at certain points of the project.

Contacts