Smoothing out the transition of care between maternity and child and family health services: perspectives of child and family health nurses and midwives'.
BACKGROUND
In Australia, women who give birth are transitioned from maternity services to child and health services once their baby is born. This horizontal integration of services is known as Transition of Care (ToC). Little is known of the scope and processes of ToC for new mothers and the most effective way to provide continuity of services. The aim of this paper is to explore and describe the ToC between maternity services to CFH services from the perspective of Australian midwives and child and family health (CFH) nurses.


METHODS
This paper reports findings from phase two of a three phase mixed methods study investigating the feasibility of implementing a national approach to CFH services in Australia (the CHoRUS study). Data were collected through a national survey of midwives (n = 655) and CFH nurses (n = 1098). Issues specifically related to ToC between maternity services and CFH services were examined using descriptive statistics and content analysis of qualitative responses.


RESULTS
Respondents described the ToC between maternity services and CFH services as problematic. Key problems identified included communication between professionals and services and transfer of client information. Issues related to staff shortages, early maternity discharge, limited interface between private and public health systems and tension around role boundaries were also reported. Midwives and CFH nurses emphasised that these issues were more difficult for families with identified social and emotional health concerns. Strategies identified by respondents to improve ToC included improving electronic transfer of information, regular meetings between maternity and CFH services, and establishment of liaison roles.


CONCLUSIONS
Significant problems exist around the ToC for all families but particularly for families with identified risks. Improved ToC will require substantial changes in information transfer processes and in the professional relationships which currently exist between maternity and CFH services.
School of Nursing and Midwifery, University of Western Sydney, Sydney, Australia. K.Psaila@uws.edu.au.
Kim
K
Psaila
Sue
S
Kruske
Cathrine
C
Fowler
Caroline
C
Homer
Virginia
V
Schmied
D001315:Australia; D002662:Child Health Services / Q000458:organization & administration*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D034742:Electronic Mail; D022143:Family Nursing / Q000458:organization & administration*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D033183:Interdisciplinary Communication; D008875:Middle Aged; D008880:Midwifery / Q000458:organization & administration*; D009774:Obstetrics / Q000458:organization & administration; D063886:Patient Discharge Summaries; D011247:Pregnancy; D024382:Professional Role; D016636:Telefacsimile; D013689:Telephone