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Individualised, flexible postnatal care: a feasibility study for a randomised controlled trial

Forster, Della A., Savage, Tracey L., McLachlan, Helen L., Gold, Lisa, Farrell, Tanya, Rayner, Jo, Yelland, Jane, Rankin, Bree and Lovell, Belinda 2014, Individualised, flexible postnatal care: a feasibility study for a randomised controlled trial, BMC Health Services Research, vol. 14, no. 569, pp. 1-13, doi: 10.1186/s12913-014-0569-2.

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Title Individualised, flexible postnatal care: a feasibility study for a randomised controlled trial
Author(s) Forster, Della A.
Savage, Tracey L.
McLachlan, Helen L.
Gold, LisaORCID iD for Gold, Lisa orcid.org/0000-0002-2733-900X
Farrell, Tanya
Rayner, Jo
Yelland, Jane
Rankin, Bree
Lovell, Belinda
Journal name BMC Health Services Research
Volume number 14
Issue number 569
Start page 1
End page 13
Total pages 13
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2014-11-25
ISSN 1472-6963
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Postnatal care
Domiciliary care
Individualised care
Early discharge
Postnatal preparation
VICTORIA
ORGANIZATION
AUSTRALIA
QUALITY
Summary Abstract
Background:
Postnatal care in hospital is often provided using defined care pathways, with limited opportunity for more refined and individualised care. We explored whether a tertiary maternity service could provide flexible, individualised early postnatal care for women in a dynamic and timely manner, and if this approach was acceptable to women.
Methods: A feasibility study was designed to inform a future randomised controlled trial to evaluate an alternative approach to postnatal care. English-speaking women at low risk of medical complications were recruited around 26 weeks gestation to explore their willingness to participate in a study of a new, flexible model of care that involved antenatal planning for early postpartum discharge with additional home-based postnatal care. The earlier women were discharged from hospital, the more home-based visits they were eligible to receive. Program uptake was measured, women’s views obtained by a postal survey sent at eight weeks postpartum and clinical data collected from medical records.
Results: Study uptake was 39% (109/277 approached). Most women (n=103) completed a postnatal care plan during pregnancy; 17% planned to leave hospital within 12 hours of giving birth and 36% planned to stay 48 hours. At eight weeks postpartum most women (90%) were positive about the concept and 88% would opt for the same program again. Of the 28% who stayed in hospital for the length they had planned, less than half (43%) received the appropriate number of home visits, and only 41% were given an option for the timing of the visit. Most (62%) stayed in hospital longer than planned (probably due to clinical complications); 11% stayed shorter than planned.
Conclusions: Women were very positive about individualised postnatal care planning that commenced during pregnancy. Given the hospital stay may be impacted by clinical factors, individualised care planning needs to continue into the postnatal period to take into account circumstances which cannot be planned for during pregnancy. However, individualised care planning during the postnatal period which incorporates a high level of flexibility may be challenging for organisations to manage and implement, and a randomised controlled trial of such an approach may not be feasible.

Language eng
DOI 10.1186/s12913-014-0569-2
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 929999
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, BioMed Central
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30069985

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.