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Open Access Research article

Discontinuities between maternity and child and family health services: health professional’s perceptions

Kim Psaila1*, Virginia Schmied2, Cathrine Fowler3 and Sue Kruske4

Author Affiliations

1 School of Nursing and Midwifery, University of Western Sydney, Parramatta Campus, Penrith South DC 1797, Penrith, NSW 2751, Australia

2 School of Nursing and Midwifery and the Family and Community Health Research Group, University of Western Sydney, Parramatta Campus, Penrith South DC 1797, Penrith, NSW 2751, Australia

3 Child & Family Health Centre for Midwifery, Child & Family Health Faculty of Nursing, Midwifery & Health University of Technology Sydney, Sydney, Australia

4 Queensland Centre for Mothers & Babies, The University of Queensland, Brisbane, Qld 4072, Australia

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BMC Health Services Research 2014, 14:4  doi:10.1186/1472-6963-14-4

Published: 6 January 2014

Abstract

Background

Continuity in the context of healthcare refers to the perception of the client that care has been connected and coherent over time. For over a decade professionals providing maternity and child and family health (CFH) services in Australia and internationally have emphasised the importance of continuity of care for women, families and children. However, continuity across maternity and CFH services remains elusive. Continuity is defined and implemented in different ways, resulting in fragmentation of care particularly at points of transition from one service or professional to another.

This paper examines the concept of continuity across the maternity and CFH service continuum from the perspectives of midwifery, CFH nursing, general practitioner (GP) and practice nurse (PN) professional leaders.

Methods

Data were collected as part of a three phase mixed methods study investigating the feasibility of implementing a national approach to CFH services in Australia (CHoRUS study). Representatives from the four participating professional groups were consulted via discussion groups, focus groups and e-conversations, which were recorded and transcribed. In total, 132 professionals participated, including 45 midwives, 60 CFH nurses, 15 general practitioners and 12 practice nurses. Transcripts were analysed using a thematic approach.

Results

‘Continuity’ was used and applied differently within and across groups. Aspects of care most valued by professionals included continuity preferably characterised by the development of a relationship with the family (relational continuity) and good communication (informational continuity). When considering managerial continuity we found professionals’ were most concerned with co-ordination of care within their own service, rather than focusing on the co-ordination between services.

Conclusion

These findings add new perspectives to understanding continuity within the maternity and CFH services continuum of care. All health professionals consulted were committed to a smooth journey for families along the continuum. Commitment to collaboration is required if service gaps are to be addressed particularly at the point of transition of care between services which was found to be particularly problematic.