The NICE Birthplace Action Study: Barriers and facilitators for the implementation of the NICE intrapartum guidelines recommendation on place of birth for women with uncomplicated pregnancies
Ellen Thaels
Imperial College Healthcare
Ellen is a clinical academic midwife expert in midwifery units. She is based clinically at Imperial College Healthcare and she works as a Research Fellow at City University of London with Professor McCourt and Dr Rocca-Ihenacho as part of the NIHR funded NICE Birthplace Action Study.
Abstract
Background, including element of originalityStrong evidence suggests that, when focusing on a population of healthy women with uncomplicated pregnancies midwifery units are safer than obstetric units, as they are associated... [ view full abstract ]
Background, including element of originality
Strong evidence suggests that, when focusing on a population of healthy women with uncomplicated pregnancies midwifery units are safer than obstetric units, as they are associated with lower rates of interventions and maternal morbidity and similar rates of adverse outcomes for newborn babies. Midwifery units have also been shown to be cost-effective.
The NICE intrapartum guidelines (2014) as well as the NICE Quality Standards (2015) recommended offering healthy women with uncomplicated pregnancies choice between four places of birth: Freestanding Midwifery Unit (FMU), Alongside Midwifery Unit (AMU), home and the Obstetric Unit (OU).
The aim of this study is to develop and evaluate a theoretically informed knowledge implementation pathway that service providers and commissioners can use as a guide to implement evidence on birthplace into NHS services which require complex organisational and professional practice change.
Methodology
A Participatory Action Research (PAR) approach is used and the Promoting Action on Research Implementation in Health Services (PARIHS) framework has been adapted to guide implementation design and evaluation. Data collection includes qualitative and quantitative methods (analysis of routinely collected data, user surveys, local audits, focus groups, field notes and in-depth interviews.
Findings
The findings presented in this paper will be specifically focused on the barriers and facilitating factors for implementation identified in the study and in prior literature.
Discussion and conclusion
The discrepancy between the national guidance and what happens in practice highlights the need for good implementation strategies which are sustainable. We will discuss the findings on barriers and levers and how these are being considered in development of the pathway.
Authors
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Ellen Thaels
(Imperial College Healthcare)
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Lucia Rocca-Ihenacho
(City, University of London)
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Laura Batinelli
(City, University of London)
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Christine McCourt
(City, University of London)
Topic Areas
1. Studies that integrate knowledge from a range of scientific approaches and/or perspecti , Studies of and contributions to practice and/or service organisation , Studies of collaboration to improve maternal, infant, family, and maternity staff wellbein , Examinations of building design and of the physical and psychosocial environment of birth , Social and cultural precursors and consequences of optimal childbirth , Emotional and spiritual aspects of labour and birthing , Educational aspects , Philosophical and theoretical critiques and debates , Methodological innovations inthis and associated areas
Session
concurr3 » Implementation and innovation (10:30 - Tuesday, 3rd October, Woodlands)
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