Читать книгу International Practice Development in Health and Social Care - Группа авторов - Страница 37

Catherine Adams, Ciaran Crowe, Crystal McLeod, and Giselle Coromandel

Best practice in maternity care can be defined by the quality triad of safety, effectiveness and person‐centredness (Berwick 2013; Royal College of Obstetricians and Gynaecologists 2016; Department of Health and Social Care 2016; Royal College of Midwives 2014). However, despite clarity about what constitutes best practice, national and international crises in relation to maternity care continue to recur. Most notably these include Portlaoise (Ireland) (Health Information and Quality Authority 2015), Djerriwarrh Health Services (Australia) (Wallace 2015) and the Morecombe Bay investigation in England (Kirkup 2015).

Despite having access to both national and international guidelines and policies and awareness of what high‐quality maternity care looks like, the biggest challenge facing maternity services is enabling what is already known (i.e. the evidence base) to be implemented and used in clinical practice. The second challenge is understanding why some maternity providers have managed to successfully implement improvements in the quality triad whilst others have not despite the same evidence base being used (Liberati et al. 2019).

Practice development (PD), whilst not a panacea for all issues in healthcare, can be a feasible and effective solution to these two challenges. Contextual readiness of your healthcare setting can be assessed for translating evidence into your practice or to evaluate your workplace culture through analysing the factors that positively influence the quality triad. As the triad is underpinned by learning (Crowe and Manley 2019) and PD has a particular focus on active learning, you could use its tools to evaluate yourself, your service or your team through each of these lenses.

PD is focused on collaboration, inclusivity and a participative approach to developing person‐centred, safe and effective cultures (Manley et al. 2008). These principles were found to be lacking in international inquiries into maternity care. Therefore, PD is a useful method to facilitate improvement and transform care.

PD, with its focus on bottom‐up change, aims to align change ideas with people’s values and generate greater buy‐in, which in turn can lead to sustaining workplace transformation.

In this chapter we will describe the experience of transformation within maternity services, drawing from four different contributors in hospital settings across different countries. Transformational PD, person‐centred, safe and effective approaches were used to facilitate effective workplace cultures to flourish. An unexpected and positive consequence of the authors’ involvement was a turning point in their awareness of the effectiveness of this methodology. The critical recognition that PD could transcend boundaries of countries, health services, professional disciplines and positions was pivotal to the authors’ commitment to this methodology in the quest for improving maternity care.