title: Collaborative practice model: Madigan Army Medical Center.
abstract: In 2007, Madigan Army Medical Center implemented a new maternity care delivery model, integrating obstetricians and certified nurse-midwives (CNMs) in a collaborative practice. The change was driven by multiple factors, including patient preference, changes in the resident workweek, and low provider satisfaction. This article describes the elements of successful collaboration, including the structure, effective teamwork principles, role of the CNM in resident education, and preliminary data on mode of delivery, the number of CNM-supervised resident births, and procedures, such as episiotomy and epidural use.
authors.affiliation: Western Regional Medical Command, BLDG 2006, Joint Base Lewis McChord, WA 98433, USA.
authors.forename: Peter E
authors.initials: PE
authors.lastname: Nielsen
authors.forename: Michelle
authors.initials: M
authors.lastname: Munroe
authors.forename: Lisa
authors.initials: L
authors.lastname: Foglia
authors.forename: Roxanne I
authors.initials: RI
authors.lastname: Piecek
authors.forename: Mary Paul
authors.initials: MP
authors.lastname: Backman
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cypher
authors.forename: Denise C
authors.initials: DC
authors.lastname: Smith
mesh_terms: D003266:Continuity of Patient Care / Q000458:organization & administration*; D003299:Cooperative Behavior; D005260:Female; D006772:Hospitals, Military / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007400:Interprofessional Relations; D009721:Nurse Midwives / Q000458:organization & administration* / Q000592:standards; D009774:Obstetrics / Q000458:organization & administration* / Q000592:standards; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D019555:Physician-Nurse Relations; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011787:Quality of Health Care; D014481:United States