A review of Workforce Deployment and Skill Mix impact on intrapartum safety
Investigators:
Sandall,J.* Homer,C. Bourgeault,I.
Bewley,S.
Project Funding: King’s Fund.
This project undertook a scoping review of the relationship between maternity workforce staffing, skill mix and deployment practices on the safety of maternity care . Database searches were limited to the English language between 1993 and January 2010 on the relationship between staffing, skill mix and staff deployment and safety and health outcomes.
Rearranging services around women has benefits for women and babies. Midwife-led care which involves continuity, for all women except the highest levels of risk, is associated with several significant clinical benefits for mothers and babies, and increased satisfaction and had no identified adverse effects and reduced costs. There is potential for support workers to be deployed more creatively in maternity services in terms of improving quality of care and freeing up midwife and medical time. Innovations at a regional level include, testing support worker/midwife ratios, the use of doulas.
There is a paucity of evidence about the impact on cost and quality and safety of care of 24 hour consultant presence, altering shift patterns, skill-mix ratios and the impact of support workers, and further research needs to be done.
Publications
Sandall,J. Homer,C. Sadler,E. Rudisill,C. Bourgeault,I. Bewley,S. Cowie,L. Nelson,P. Cooper,C.(in press) Maternity safety, workforce deployment and skill mix, Report to the King’s Fund.