Gone awry: planned birth variations
A new study reveals the extent of planned birth variation, and the perception and readiness for change, in Australian public hospitals.
The inconsistent uptake of evidence has resulted in unnecessary variation in all areas of health care practice – including in maternity care.
Variation in planned birth practices, such as the induction of labour and pre-labour caesarean section, is of increasing concern.
While there are evidence-based guidelines surrounding planned birth practices, including when to induce labour and perform a caesarean section, the extent to which these are followed by clinicians remains unclear.
A recent study sought to identify inter-hospital and inter-professional variations in relation to current planned birth practices, as well as readiness for change.
Led by Adjunct Associate Professor Dominiek Coates, the research focused on public maternity units in hospitals across Sydney.
Adjunct Associate Professor Coates says that the purpose of the study was two-fold.
“We were interested in examining both planned birth practices as well as perception of the need for and readiness for change,” she says.
Using a custom-created survey, the study found significant inter-hospital and inter-professional variation in perceptions of hospital planned birth practices, and requirement for and readiness for change of such practices.
The study confirmed the significant variation in the uptake of evidence-based guidelines between hospitals.
“Our findings showed significant variation between the units on both their beliefs about their units’ practices, some of which conflict with the evidence, and their readiness to change,” Adjunct Associate Professor Coates says.
We also found that hospitals with greatest staff perception of need for change also perceived least resources to implement such change.
Adjunct Associate Professor Dominiek Coates
The study also showed substantial inter-professional variation, with disagreements between midwives and medical staff on how they view their hospital practices. This particular concern is an area that participating hospitals are already looking to resolve.
“Because of our study, participating hospitals are currently working towards training in shared decision-making for both medical and midwifery staff,” Adjunct Associate Professor Coates says.
Read the full article here: Inter-hospital and inter-disciplinary variation in planned birth practices and readiness for change: a survey study [opens external site]
