References
A qualitative exploration of midwives' and ambulance clinicians' experiences working together
Abstract
Background/Aims
Effective teamwork represents a significant component of high-quality maternity care. Midwives and ambulance clinicians are sometimes required to work together in the pre-hospital setting, but these interactions are not well documented or understood. This study aimed to explore the views and experiences of clinicians, to describe the barriers to and facilitators of effective teamwork in this context.
Methods
Focus group discussions and in-depth interviews were conducted with 30 London-based clinicians who had experience of providing emergency maternity care in the pre-hospital setting as part of a multidisciplinary team. Data were analysed thematically, informed by principles of grounded theory.
Results
Three overarching themes emerged: significance of the patient environment, reaching a shared mental model and interpersonal dynamics. Challenges included conflicting priorities and lack of understanding each other's roles and skillsets. Civility and multidisciplinary training were perceived as conducive to effective teamwork.
Conclusions
The findings provide insight to the factors that were perceived to impact teamwork in a pre-hospital maternity context. Actions to improve patient safety include increased partnership working between acute and ambulance trusts, including the provision of multidisciplinary training.
Implications for practice
Midwives and ambulance clinicians report a shared goal of a safe and positive experience for the families in their care. When working towards these outcomes, teams require leadership that acknowledges the various professional remits present.
Maternal and newborn health is a cornerstone for public health and human development (World Health Organization and UNICEF, 2023). While the UK has a low incidence of perinatal morbidity and mortality when compared with global figures, there has been a concerning plateau in the number of adverse outcomes over recent years (Knight et al, 2023), particularly in comparison to other similarly resourced countries (Diguisto et al, 2022). National efforts to reduce stillbirth rates were hindered by the COVID-19 pandemic (NHS England, 2023) and the maternal mortality rate has seen a statistically significant increase (Felker et al, 2024). London has more births per year than any other region in the UK (Office for National Statistics, 2022) and its maternity services are challenged with chronic staffing issues (NHS England and NHS Improvement, 2019) and higher rates of medical complexity and social disadvantage (Bewley and Helleur, 2012). There is discussion on how such pressures can displace risk into the community, with implications for ambulance services (Heys et al, 2023).
Register now to continue reading
Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:
What's included
-
Limited access to our clinical or professional articles
-
New content and clinical newsletter updates each month