VIP Call Girl Sector 25 Gurgaon Just Call Me 9899900591
Improving Maternal Health Outcomes by Engaging Family
1. Improving Maternal and Neonatal Health
Outcomes by Engaging the Whole Family
Duncan Fisher, OBE
Luis Figueira
| CEO, Maternity Assist
| Cloud Lead, Boxfusion Consulting
Oracle Open World
San Francisco, September 29th 2014
2.
3. In 2012, there were the equivalent of
20,935 full-time midwives working in the
NHS in England.
https://www.rcm.org.uk/sites/default/files/State%20of%20Maternity%20Services%20report%202013.pdf
In 2012 there were 694,241
babies born in England
The RMC’s assessment of the shortage of
midwives in the NHS in England in 2012 is
around 4,800.
but the number of midwives
working in the NHS in that
year was only really suitable
for 565,245 births
meaning there were 128,996
more births than the service was
designed to cope with.
+23%
+23%
4. NHS midwives in England are
getting older. The largest age
group in 2001 was midwives
aged between 35 and 39; the
largest age group in 2012 was
those aged 45 to 49.
https://www.rcm.org.uk/sites/default/files/State%20of%20Maternity%20Services%20report%202013.pdf
5. https://www.rcm.org.uk/sites/default/files/State%20of%20Maternity%20Services%20report%202013.pdf
The effect of the higher number of births is multiplied by the growing complexity of pregnancies. For example:
Increase in the number of births to older
women
Older women require more assistance
from midwives. They have a perfect right
to all that additional care, of course, but
it has an undeniable knock-on effect on
workload.
+12345678050%
6. https://www.rcm.org.uk/sites/default/files/State%20of%20Maternity%20Services%20report%202013.pdf
The effect of the higher number of births is multiplied by the growing complexity of pregnancies. For example:
Obesity in pregnancy
The incidence of maternal obesity in the first three months
of pregnancy in England more than doubled from 7.6% to
15.6% between 1989 and 2007.
The result is extra women requiring more demanding care.
7.6%
7. “[…] things are beginning to change – with a range of pressures making the work of
midwives ever more challenging, unrewarding, and potentially dangerous for patients.”
“[…] As such, it is not just a change in the birth rate that increases the work load for
midwives, but the management of the array of needs for each individual woman.”
http://www.independent.co.uk/life-style/health-and-families/health-news/a-call-from-the-midwife-why-i-am-resigning-after-10-years-in-the-nhs-9035417.html
8. Slide with 55 items that need to be covered in the 45 min appointment
9. Quality issues
For patients:
Access of content online (where current generation lives)
Curation of information
Well-scheduled interactive information spread through the pregnancy instead of a barrowful of
leaflets at the start
Convenience / preference – easy ways to ask questions and raise worries outside antenatal
appointments
For NHS:
There are concerns about the quality of information found on the internet
Public health concerns, antenatal education, youth services for young parents, … introducing
people to local services (housing, benefits)
Save midwives’ time for higher risk families
Identify concerns of patients and their families early before they escalate
10. “Due to understaffing I regularly
work for nearly 13 hours without
a break […]. These tasks are
essential to maintain the safety
of women and their babies.”
14. Maternity Assist
Features
Expectant mothers nominate other family members
Self-help questionnaires
On-line 24/7 content library
“Ask-a-midwife” a question
Linked to hospital records
Multi-channel: email, twitter, phone, …
15. Maternity Assist
Features
Benefits
Relieving Expectant overload mothers of nominate communications other family to families
members
Making Self-help maternity questionnaires
services more accessible
Systematically On-line 24/7 content communicating library
health/social
information
“Ask-a-midwife” a question
Engaging Linked to the hospital whole records
family
Multi-channel: email, twitter, phone, …
17. [Demo of:
- Registration process for mothers & F&F
- Pregnancy information on midwife’s console: friends and family, relationship to baby
- Segmentation based on above
- Look at how different types of users receive different information]
18. [Demo of:
- Segmentation based on weeks pregnant
- Mailings on different pregnancy stages to different people]
24. Family centred care: the evidence
Social networks and smoking reduction
• Smoking throughout pregnancy is one of the single most important avoidable causes of adverse
pregnancy outcomes.
• Approximately one quarter of German mothers smoked during pregnancy.
Aveyard, P., Lawrence, T., Evans, O., & Cheng, K. K. (2005). The influence of in-pregnancy
smoking cessation programmes on partner quitting and women's social support
mobilization: a randomized controlled trial ISRCTN89131885. [Article]. Bmc Public Health,
5. doi: 10.1186/1471-2458-5-80
Nguyen, S. N., Von Kohorn, I., Schulman-Green, D., & Colson, E. R. (2012). The Importance
of Social Networks on Smoking: Perspectives of Women Who Quit Smoking During
Pregnancy. [Article]. Maternal and Child Health Journal, 16(6), 1312-1318. doi:
10.1007/s10995-011-0896-4
25. Family centred care: the evidence
Engaging fathers saves babies’ lives
• Men‘s dominance in household and community decision-making
in Niger, coupled with their lack of knowledge about the
advantages of clinical care in childbirth, mean that many women
are continuing to give birth at home, unattended. A mother dies
in childbirth, and 6 newborn babies die, every two hours in Niger.
• A total of 1600 men are now involved in the scheme. In one
district […] the rate of attended childbirth [rose] from 15% to 74%
of births
http://www.fatherhoodinstitute.org/2013/case-study-husband-schools-in-niger/
26. Family centred care: global interest
“To prevent mental health disorders, we need to prevent
childhood adversities, and for this we need family-focused
policies that strengthen the capabilities of parents to reduce
violence, illness, and poor functioning.”
Prof Panter-Brick, Yale University, at UN Forum in June 2014, "The Significance of Parents for Human Development”
Report on UN Forum, "The Significance of Parents for Human Development”, June 2014
http://www.upf.org/global-day-of-parents-2014/5943-forum-at-the-un-discusses-the-significance-of-parents-for-human-and-societal-development
Editor's Notes
Don’t say there is too much complexity, say the midwife is very important [midwife at the centre]
Focus on quality of care and communications
This slide is about midwives are influencing a large number of people (not just mothers but also their families). The midwife is at the hub, they are very important individuals.
Midwives are the most trusted individual for mothers
Current generation: 100% mobile, 90% confidence in using internet, exponential growth in ownership of smartphones (ofcom communications market report, 2011), 90% of pregnant women access the internet for pregnancy information
Maternity care in UK under intense pressure:
- increasing birth rate and increasing proportion of special needs, e.g. obesity
- excessive communication needs - e.g. in one service, 55 issues to discuss in one 45 minute appointment
- British midwives currently voting on a national strike in protests at under-investment
Opportunities in UK
- NHS policy: develop digital communications in health care for quality, convenience and cost saving
- frontline midwives support change: better comms = better service = better work
- expectant parents particularly amenable to health information
- parents responsive to information during pregnancy
- better outcomes achieved when "team around baby" engaged, not just "primary carer"
Midwives, GPs and registrars to help tackle family breakdown
Iain Duncan Smith, the Work and Pensions Secretary, is considering enlisting the support of midwives, GPs and registrars to help reduce the levels of family breakdown (+1 to the 55)
So, what CAN we do?
Web Self Service
Empower customers to easily self-solve their issues anywhere
Social Self Service
Enable collaboration for support issues on your website and Facebook
Email Support
Receive answers and manage responses through email, SMS and web
Live Chat
Chat with customers through assisted online service interactions
Virtual Assistant
Handhold customers across online points of contact to resolution
Smart Engagement
Intelligently engage with customers on every touch point
Case Management
Manage timely resolution of incidents across all your channels
Guided Resolution
Dynamically capture critical information through guided dialogues
Customer Engagement
Personalize proactive communications with your customers from deep service profiles
Social Contact Center
Infuse social listening and engagement into the contact center
Agent Mobility
Enable agents to resolve issues even when away from their desk
Unified Agent Desktop
Integrate other systems into one unified experience for your agents
Content Authoring
Rapidly deliver knowledge through complex workflow approvals
Semantic Search
Find relevant answers from any repository in any format, in native languages
Guided Knowledge
Create Guided flows for navigating users to the right answers across multiple content sources
Knowledge Analytics
Gain deeper insight into customer interactions and knowledge gaps
Integrated Apps
Deliver knowledge at the point of need using Web Self Service and Contact Center Apps
Knowledge APIs
Leveraging customer context and data from external systems for step by step guidance
Families are overloaded with online information and there is concern about its quality; heads of midwifery services want midwives to act as curators
Engaging “community of care” round mother and baby brings better outcomes – nutrition, stress education, mental health, family violence, smoking1, alcohol, baby death
Given that women and their partners often stopped smoking together, future interventions to prevent smoking in pregnant women could encourage both partners to quit together.
Despite the importance of partner smoking, there are very few effective smoking cessation interventions for pregnant/postpartum women that include or target male partners, suggesting the need for further intervention development and research to establish the utility of this approach.
Collaboration within the family creates better care
Greater involvement of fathers brings range of benefits: greater attachment to child, better support for health of mothers
Major study in 2014 at Yale University: all parenting interventions should engage fathers