Postnatal care is the neglected part of maternity services. As it is a 'low risk' clinical area, it receives the least attention, money and drive. However, it is the postnatal experience that can shape the woman’s entire maternity journey and create a lasting impression of the hospital and their pregnancy.
The postnatal ward and services involve collaborative work between midwives, obstetricians, paediatricians, breastfeeding support workers, healthcare assistants, the hearing screening team and management. With such a multi-disciplinary and constantly changing workforce, it is hard to make coordinated attempts at change. The process that best illustrates the system's flaws is the discharge process. There is no clear and efficient process in place for this. This means that there are often significant delays caused by poor communication between the multi-disciplinary team (MDT), a disjointed system and duplication of work. Ultimately, this leads to delayed patient discharges, a stressed cohort of staff and a frustrated group of patients.
Patient frustration is sadly illustrated by the significant number of complaints within the maternity division that originate from postnatal care. The benefit of receiving such complaints is that they help to reveal system vulnerabilities and by addressing these issues, we could achieve a higher standard of care.
To investigate the problems and identify the areas for improvement, there was a multi-faceted approach:
• 96 postnatal patient Surveys/Structured interviews• 6 postnatal ward Spot Checks to identify recurring trends leading to delayed discharge
• 3 postnatal patient journeys-in depth patient diaries to described their experience
• 2 postnatal Staff Focus Groups
• Maternity Staff Workshop-45 attendants
So the aim is to improve patient care, reducing the impatient stay and stream-lining the discharge process through enhanced teamwork by implementing a new booklet and animated video (https://www.youtube.com/watch?v=UaoM7xLOqcM), a structured MTD ‘discharge talk’ for all women, and the opening of a new Maternity Lounge.
Complete with comfortable new sofas, the refurbished space provides a relaxing, informal environment for parents to prepare to go home with their new baby. Breastfeeding support is provided, and a midwife, physiotherapist, plus obstetric and paediatric doctors all drop in to discuss any concerns before women go home. Parents can also talk to each other, share tips and give encouragement.
As well as redecorating the discharge lounge, staff compiled various information leaflets into a comprehensive pack which has also been made into a video. To encourage people to take note of the guidance, the short video is played on a screen in the lounge, as well as being available online to view at home.
The team hope that by providing improved information alongside peer support, midwives will be freed up to spend more time with women who have additional needs or experienced difficult pregnancies. This will reduce delays in discharge, ensuring the ward has capacity to continue to provide high quality, safe care.On 12th April we had a formal opening the new Maternity Lounge on Mulberry Ward where we introduced the new MDT postnatal ‘talk’ available to all women before discharge home, the Launch of the new ‘Going Home’ postnatal booklet the launch of the new postnatal information video.
for further information please contact [email protected], mobile - 07798571439