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Research Issues in the Assessment of Birth Settings: Workforce Issues

Research Issues in the Assessment of Birth Settings: Workforce Issues. Susan Stapleton, DNP, CNM, FACNM. Workforce Issues: What We Know. Level of acuity of hospital-based intrapartum care has increased due, in part, to higher rates of labor induction & cesarean birth.

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Research Issues in the Assessment of Birth Settings: Workforce Issues

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  1. Research Issues in the Assessment of Birth Settings: Workforce Issues Susan Stapleton, DNP, CNM, FACNM

  2. Workforce Issues: What We Know • Level of acuity of hospital-based intrapartum care has increased due, in part, to higher rates of labor induction & cesarean birth. • Some U.S. perinatal outcomes are worsening. • Competent, educated nurses improve patient outcomes. • Births attended by midwives or occurring outside the hospital have increased. • Transitions from one setting to another or one provider to another are associated with increased adverse outcomes – handoffs require a high level of care & coordination.

  3. Workforce Issues: What We Know • Need to expand & fully utilize women’s health provider workforce is urgent. • Collaborative teams of maternity care providers improve outcomes & lower costs. • Current education model tends to reinforce barriers to working collaboratively & is disparate in terms of resources devoted to different providers.

  4. Workforce Issues:What We Need to Know • How does nurse staffing affect quality, safety, and cost of hospital-based perinatal care? • Impact of “missed nursing care” on perinatal outcomes – including breastfeeding measures. • Impact of technology & EHR on workforce training needs & demand? • Impact of patient engagement & shared decision-making models on workforce training & staffing needs?

  5. Workforce Issues:What We Need to Know • Cost &outcome implications for new models that rely on perinatal teams providing collaborative care? • What provider ratios are optimal for full utilization of the workforce & for high value care? • Are we currently utilizing our workforce to the full extent of their education, training & scope of practice? What are the barriers & incentives? • What new team members can be added to improve outcomes & decrease cost – e.g. peer support?

  6. Workforce Issues:What We Need to Know • What professional education model(s) will prepare health care providers to function as part of collaborative teams? • What changes are needed in graduate education funding to develop these models? • What are “best practices” to develop & maintain competency of perinatal teams in responding to need for transfer from one birth setting to another?

  7. Workforce Issues:What We Need to Know • What are exemplary U.S.- and non-U.S.-based models of collaborative practice & how can they best be replicated? • What institutional support and incentives are needed to support collaborative practice models at the health care system level? • How can we foster multidisciplinary collaboration among maternity professionals through payment reform?

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