Dr Chamani Kodikara1, Ms Eleanor Johnson1,2, Dr Rebecca Jessup1,3, Dr Vinita Rane1,2, Dr Siaw Hui Wong1,4
1The Northern Hospital, Epping, Melbourne, Australia, 2University of Melbourne, Parkville, Melbourne, Australia, 3La Trobe University, Bundoora, Melbourne, Australia, 4Mercy Hospital for Women, Heidelberg, Melbourne, Australia
Biography:
Biographies to come
Abstract:
Background: The Medical Obstetrics at Home service (MOAH) at Northern Health in Melbourne, Victoria, Australia is an innovative care model serviced by Midwives and Obstetric Medicine Physicians, providing home-based care to two groups of patients – those with hyperemesis gravidarum and those with hypertensive disorders of pregnancy. Through home visits and telehealth consultations, the team reviews patients’ Pregnancy Unique Quantification of Emesis (PUQE-24) score or blood pressure readings, gives advice on medication adjustments, issues prescriptions for antiemetic and antihypertensive medications, and delivers intravenous medications and fluid therapy.
There is a growing body of evidence that patient experience has a profound impact on health outcomes, highlighting the importance of evaluating this to optimise healthcare delivery¹. A positive experience of maternity care can improve engagement, health-seeking behaviour, and enhance health outcomes. Perceptions of proposed home-based models of care² and telemonitoring in the obstetric population³ have been studied, however there are no published qualitative studies regarding patient experience of an established program like MOAH.
Method: This cross-sectional qualitative research study aims to understand patients' experience of MOAH. Patients who received care through MOAH are invited to participate in individual semi-structured interviews. A professional interpreter will be organised to translate during the interview as required. Discussion will include the impact of MOAH on quality of life and ability to fulfil personal/professional duties, and negative aspects and suggestions for improvement.
Results and Conclusion: Pilot work suggested several common themes. Patients felt safer with a discharge home with MOAH; felt the emotional support and advocacy were valuable; felt home-based consultations and therapies were more convenient; and felt that MOAH facilitated a more comfortable recovery.
Findings from this study, in conjunction with other analyses of health outcomes and economic impact, will inform service optimisation and may support scalability of the model of care to other maternity hospitals.
Keywords
Hyperemesis Gravidarum, Hypertensive Disorders of Pregnancy, Home based service
References
1. Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ open. 2013;3(1)
2. Mohammadi F, Kohan S, Yarmohammadian M, Savabi-Esfahani M, Rastegari Z. Exploring Potential Achievements and Barriers to Provide Homecare for Women with Preeclampsia: A Qualitative Study. Int J Community Based Nurs Midwifery. 2022;10(1):30-41
3. Aasbø G, Staff AC, Blix E, Pay ASD, Waldum Å, Rivedal S, Solbraekke KN. Expectations related to home-based telemonitoring of high-risk pregnancies: A qualitative study addressing healthcare providers' and users' views in Norway. Acta Obstet Gynecol Scand. 2024 Feb;103(2):276-285.