title: Making it work: successful collaborative practice.
abstract: There are three major examples of collaborative programs between certified nurse-midwives (CNMs) and obstetrician-gynecologists at Baystate Medical Center in Springfield, Massachusetts, within the Department of Obstetrics and Gynecology. One program is a midwifery practice that serves a diverse population in a hospital-based office, four neighborhood health centers, and a correctional facility. Another program provides a triage function for patients who present to the hospital with obstetric or gynecologic problems. The third program introduces a team approach to the education of residents with a CNM having primary responsibility for teaching normal obstetrics to first-year residents and medical students in collaboration with attending physicians. Keys to success include an understanding of the principles of collaborative practice, the use of a detailed practice agreement between midwives and attending physicians, keeping open lines of communication, understanding and accepting differing philosophies of practice, and, most importantly, maintaining trust across all levels of providers.
authors.affiliation: From the Division of Midwifery and Community Health, Division of General Obstetrics and Gynecology, and Obstetrics and Gynecology Residency Program, Baystate Medical Center, Springfield, Massachusetts; and Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Susan
authors.initials: S
authors.lastname: DeJoy
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Burkman
authors.forename: Barbara W
authors.initials: BW
authors.lastname: Graves
authors.forename: Daniel
authors.initials: D
authors.lastname: Grow
authors.forename: Heather Z
authors.initials: HZ
authors.lastname: Sankey
authors.forename: Carolyn
authors.initials: C
authors.lastname: Delk
authors.forename: Julie
authors.initials: J
authors.lastname: Feinland
authors.forename: Janet
authors.initials: J
authors.lastname: Kaplan
authors.forename: Anastasia
authors.initials: A
authors.lastname: Hallisey
mesh_terms: D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D008404:Massachusetts; D008427:Maternal Health Services / Q000458:organization & administration*; D008880:Midwifery / Q000458:organization & administration*; D017146:Models, Organizational; D009774:Obstetrics / Q000193:education / Q000458:organization & administration*; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration*; D019555:Physician-Nurse Relations; D011247:Pregnancy