2-way communication for family-centred, individualised birth planning and informed decision-making
What is the challenge your project is going to address and how does it connect to the theme?
Thousands of babies in England are being born preterm, smaller than expected, or stillborn because of socio-economic and racial inequalities across the country. We need to improve antenatal planning for women with diverse and complex needs, to support them in making informed and timely decisions regarding their birth choices.
– Inequity of information for women who have English as an additional language
– Women requesting caesarean birth without medical indication
– Women with obstetric risk factors requesting a midwife-led birth at home or in a birth centre
– Lack of continuity of care with women not seeing the MDT member at the right time
– Women tell us they feel frustrated, disempowered and anxious.
Facilitating maternal choice and informed decision-making is critical to women feeling empowered psychologically and physically to bond with and care for their newborn. We need to modernise the way information moves between women and health care professionals (HCPs).
What does your project aim to achieve?
Co-production of a “Birth Options pathway” that utilises digital tools to facilitate family-centred, culturally-sensitive, informed decision-making in complex birth planning. We’ve already started testing improvement ideas and have learnt outcomes women want:
– individualised senior Obstetric and Midwifery (MDT) counselling, by HCPs interested in complex birth planning (takes experience, patience, motivational interviewing skills);
– access to information early in the antenatal period;
– choice of various formats (video, audio, text), including language options;
– A written birth plan confirmed in notes as soon as possible, to reduce anxieties
– video calling services – partner and patient can join in together, in comfort of home;
– Having a HCP who is a clear point of contact to ask further clarifying questions or to confirm a decision.
– Time taken from referral to confirmed birth plan
– Qualitative measures regarding staff and women’s satisfaction with the process
How will the project be delivered?
Ideas we want to test:
– Dedicated Video calling clinic with a Consultant Obstetrician and Midwife working together for initial consultation
– Utilising a digital platform with a chat function between women and HCPs (has been shown to work in other MedTech applications) instead of relying on follow-up appointments, with messages saved seamlessly on electronic patient record (EPR)
– VIDEO (+ translated captions)/LEAFLET (+ translated language options)/AUDIO (patient choice as to which they want to engage with) that HCP can share
– birth plan co-produced by woman and HCP, visible on EPR. (+translated language options)
Ideally we would use 1 application to deliver all of the above, but recognise this may be challenging. There is already some work being done in this space. We would find ways to integrate and promote existing digital resources, many of which have patchy uptake at present (e.g Northwest London Mum and Baby app, Patient Knows Best, iDecide)
How is your project going to share learning?
This project will explore how HCPs interact with women outside of the traditional clinic model, a concept that is applicable to any and every healthcare encounter involving informed decision-making. We will share learning from our evidence-based qualitative and quantitative data, openly and honestly with organisations.
Birth planning is an ever more important and time consuming part of routine obstetric care. Every maternity department in the UK is experiencing workforce challenges, in addition to integrating the new demands and expectations from women and national bodies. Developing a robust, sustainable and safe system to enable two-way communication between HCP and women (including non-English speakers), will improve the experience for families and staff. If targeted and executed well, this aspect of antenatal care and intrapartum preparation has the potential to improve outcomes for the most vulnerable women and babies. Our learning will have infinite applications in enabling patient-centred decision-making.
How you can contribute
- Critical Friend - has this been tried elsewhere? Where are our blind spots?
- Collaborator - do you have a digital platform that we can work with to provide video calling, information sharing, and asynchronous text messaging securely between patients and HCPs? Any chance this will integrate with Cerner?
- Strategist - are you aware of any national programmes with the same aim or addressing similar issues? What other measures can you suggest? Any additional resources required?
- Investor - would you like to invest in our project? It has the potential to be huge!
- Networker - any other Q projects or similar projects that you know of? This is such a huge issue we can't be the only ones wanting to work on this.
- Expert - User Experience expertise or digital expertise welcome.
|31 May 2022||Concurrent Communications drive for CIE uptake (or Mum & Baby app)|
|31 May 2022||Concurrent production/collation of patient information (some already exist)|
|31 May 2022||PLAN - various digital platforms we can test (start with CIE?)|
|31 May 2022||Start seeing women in MDT Birth Counselling Video clinics|
|1 Jun 2022||Q Funding bid successful!|
|30 Jun 2022||Concurrent engagement with translation apps/tools for video/leaflets|
|30 Jun 2022||Engagement of stakeholders, recruit Project Manager|
|31 Jul 2022||Tested various digital platforms, confirm which we will adopt + scale|
|31 Aug 2022||Ongoing data collection qualitative + time taken to agree birth plan|
|31 Dec 2022||6 month review of learning and reflection on data/human resource|