Starting Well Initiative
Overview
The Health Alliance led an initiative between Metro North Health and Brisbane North PHN to improve access to maternity services in Caboolture.
With a focus on testing the impact of improved access to maternity and infant care on the health outcomes of mothers and babies, the Starting Well Initiative trialled the co-location of maternity and child health services in the same facility, providing families with easier access to ongoing care during pregnancy and beyond.
The results of this pilot program showed not only an increased uptake in child health services, but a greater number of babies born at full term and within the normal weight range.
Other significant achievements of the initiative showed:
- 100 per cent of patients saying that having the same mid-wife throughout their pregnancy and postnatal period made their overall care experience much better
- 50 per cent increase in people turning up for postnatal appointments
- 25 per cent increase in people turning up for antenatal appointments
- 5 per cent increase in babies being born at full term
- 3 per cent increase in babies being born in the normal birth rate
- 2.7 per cent increase in people turning up to use the Core Maternity Service at the Caboolture Hospital.
Another key success of the Starting Well Initiative was the improved satisfaction of both maternity services and the Child Health Service who were able to build stronger, more collaborative working relationships.
The Starting Well Initiative has now been adopted as a key part of business as usual at Caboolture Hospital.
Approach
The Starting Well Initiative was established to improve access to antenatal and postnatal care in the Caboolture region.
The initiative sought to test the relationship between access to maternity and child health services against the health outcomes of mothers and babies.
It was specifically designed by local clinicians and families to provide support to maternity, child health and primary care services and help them work collaboratively to provide personal care to children and families across the Caboolture region.
By bringing together key stakeholders to help co-design a new way of care, the Alliance was able to find a new way to support better collaboration between Caboolture Maternity Services, Child Health Services, local GPs and practice nurses.
Key actions supported in the pilot program included:
- co-locating midwives with the child health service in the community
- ensuring continuity of care during the antenatal and postnatal period
- introducing child health services in the antenatal period or when suitable for mothers, as well as referring siblings to the child health service
- supporting warmer handovers between maternity services and child health services through a joint home visit
- improving communication with primary care throughout (letters to GPs are required if care plan changes)
- re-engaging midwives with patients transferred to high-risk units, to ensure Children’s Health Queensland handover.
The pilot program focussed on families who were showing signs of vulnerability and planned on giving birth at Caboolture (public) Hospital.
The pilot program was run between February 2020 and October 2021 with 97 women participating in some or all of the services offered.
Outcomes
Some of the many positive outcomes of The Starting Well Initiative include:
- stronger collaboration between maternity and child health teams
- greater number of antenatal and postnatal appointments, and a reduction in failure to attend rates
- more babies being born full-term
- more babies born within healthy weight ranges.
The initiative also identified areas where further work was needed such as ensuring better communication and more emphasis on building stronger relationships with general practices within the community.
With babies born as part of the initiative demonstrating positive clinical outcomes and both mothers and staff reporting positive experiences with the program, the Starting Well Initiative has been implemented as part of business-as-usual activities at Caboolture Hospital.
At the conclusion of the pilot program, the Alliance made five recommendations for expanding the initiative including:
- building the capacity of the Starting Well Initiative to help all pregnant women in the wider Caboolture region
- using the Starting Well Initiative to continue strengthening and building its networks with primary care and health providers in the Caboolture region
- expanding key parts of the Starting Well Initiative to core maternity services at Caboolture Hospital (including continuity model for rostering and SMS access)
- rolling out the Starting Well Initiative to other hospitals in the Metro North Health region (Redcliffe, Caboolture, Royal Brisbane and Women’s Hospital)
- developing a long-term study of young women and children’s progress and outcomes related to the Starting Well Initiative and Child Health involvement.
