A toolkit for reopening remote birthing services: enablers, barriers, tasks and processes

Stewart, Ruth, and Evans, Rebecca (2017) A toolkit for reopening remote birthing services: enablers, barriers, tasks and processes. In: Proceedings of the 14th National Rural Health Conference. From: 14th National Rural Health Conference, 26-29 April 2017, Cairns, QLD, Australia.

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Abstract

Background: Rural and remote birthing services have been closing for several decades. The rationale behind these closures are concerns about safety, economic resources, and professional indemnity. Such closures have considerable implications for patients and the community, workforce and local health service provision. Many non-metropolitan community members continue to lobby for the reinstatement of local birthing care they want safe, equitable service access and, high quality care. After many years of closures, the state of Queensland in Australia has seen increased interest and success in restarting remote birthing services. There are significant challenges to be overcome for any birthing service to restart, including ensuring: appropriate skills amongst staff, consideration of community expectations, equipment availability, navigating health system requirements and the politics of the time. Those wishing to reopen a rural birthing service would benefit from understanding the essential tasks and processes required and the enablers and barriers to achieving this. Analysing and collating this data from a number of services into a ‘toolkit’ may assist the direction of other remote health services seeking to reopen birthing care after a period of closure.

Aim: This paper will outline results from the first case study of a reopened birthing service in a remote northern Queensland health service.

Methods: A qualitative, case study approach was employed to investigate key enablers, barriers, tasks and processes associated with reopening a remote birthing service. Purposive sampling was used to identify key stakeholders and actors throughout the system including clinical and support staff, local service managers, community advocates and those in relevant district management roles. These actors were invited to participate in individual semi-structured, in-depth interviews during which they discussed the experience of reopening the birthing service from their perspective; highlighting enablers, challenges, and important influences. Interviews were transcribed and analysed using an iterative, thematic technique.

Results: Qualitative analysis of the results found key enablers, barriers, tasks and processes can be categorised into thematic groups; the largest of which were associated with workforce, funding and safety. These will be discussed in light of the timeline for reopening: from initial groundwork required to start the process, service reopening and then ongoing concerns after the service recommences. The contextual factors surrounding the service recommencing are presented from community, staff and political perspectives.

Item ID: 49957
Item Type: Conference Item (Research - E1)
ISSN: 1445 3363
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Date Deposited: 25 Aug 2017 05:41
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1114 Paediatrics and Reproductive Medicine > 111402 Obstetrics and Gynaecology @ 50%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 100%
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