An empirical investigation into beliefs about collaborative practice among maternity care providers

Abstract

Objective. To investigate agreement with the National Health and Medical Research Council (NHMRC) definition of collaboration in maternity care by care providers, and to examine their preferences for models of care in order to shed light on the lack of success in implementing collaborative practice. Methods. Maternity care providers completed a survey in Queensland. The final sample consisted of 337 participants, including 281 midwives (83.38%), 35 obstetricians (10.39%), and 21 general practitioners (6.23%). Results. Ninety-one percent of the participants agreed with the NHMRC definition of collaboration: Midwives (M≤5.97, s.d.≤1.2) and doctors (obstetricians and general practitioners: M≤5.7, s.d.≤1.35) did not differ significantly in their level of agreement with definition (t (332)≤-1.8, P≤.068). However, 72% of doctors endorsed a doctor-led model of care, whereas only 6.8% of midwives indicated agreement with it. Fewer (56%) doctors agreed with the midwife-led model of care, whereas 99.3% of midwives endorsed it. Conclusion. The concept of collaboration does not recognise the different interpretations by midwives and doctors of its impact on their roles and behaviours. Successful collaborative practice requires the development of guidelines that recognise these differences and specify the communication behaviour that would assist midwives and doctors to practice collaboratively. What is known about the topic? Across all healthcare contexts effective communication is a critical part of good patient care. Effective communication refers to communication between care providers and patients but also between different interprofessional care providers. In the area of maternity care one aspect of effective communication between maternity care providers is collaborative care. This paper highlights why collaborative care and effective communication between maternity care providers is lacking. We demonstrate that the NHMRC guidelines are interpreted differently according to the different professional role of the maternity care provider. What does this paper add? This paper empirically investigates the perceptions of maternity care providers. It shows that each maternity care profession has a different understanding about what collaboration means in practice. This paper acknowledges these different perceptions, which are usually not noted, and builds on this fact to improve effective communication and bring about collaborative care. What are the implications for practitioners? In this paper, we highlight that while maternity care practitioners all aspire to collaborative care, their perceptions of what collaborative care actually means differs according to professional role. For practitioners to move forward they must develop guidelines that take account of the respective philosophies and levels of different expertise each maternity care profession brings to a woman's care. The guidelines will assist obstetricians and midwives to recognise their unique and specific areas of expertise, each of which may be required at different times according to a woman's medical needs. This new approach to interprofessional differences will bring about trust and respect and assist collaborative care. © AHHA 2012.