title: Shared maternity care: all care--not enough responsibility? An audit of patient care communications pre- and post- a multi-faceted intervention.
abstract: BACKGROUND
  Shared maternity care is an important model of care in Australia and overseas, but Victorian studies have shown patient dissatisfaction and widespread communication problems.
  
  
  OBJECTIVE
  This study aimed to implement and evaluate initiatives to improve communication between three maternity hospitals and general practitioners involved in shared maternity care in Melbourne.
  
  
  METHODS
  A pre- and post-design with audit of 150 hospital records at each of three hospitals plus audit of 20 general practitioner files for evidence of key communications on shared care patients, before and after a multifaceted intervention.
  
  
  RESULTS
  Significant improvements at individual hospitals were seen if one person was made responsible for a communication outcome. Other initiatives did not lead to improvements if they did not include individual accountability.
  
  
  CONCLUSIONS
  The standard of integration of shared maternity care is unacceptable low. Improvements to communication are achievable but depend on the allocation of individual time and responsibility, plus a commitment by hospitals to ongoing audit of their performance.
authors.affiliation: Mercy Hospital for Women, University of Melbourne, Melbourne, Australia. s.nicolson@unimelb.edu.au
authors.forename: Susan
authors.initials: S
authors.lastname: Nicolson
authors.forename: Marie
authors.initials: M
authors.lastname: Pirotta
authors.forename: Patty
authors.initials: P
authors.lastname: Chondros
mesh_terms: D005194:Family Practice / Q000592:standards*; D005260:Female; D006755:Hospital Shared Services / Q000592:standards*; D006771:Hospitals, Maternity / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D033183:Interdisciplinary Communication; D008427:Maternal Health Services / Q000458:organization & administration / Q000592:standards*; D008485:Medical Audit; D010348:Patient Care Team / Q000458:organization & administration; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards; D011336:Probability; D011785:Quality Assurance, Health Care; D012941:Social Responsibility; D014739:Victoria