The nature and impact of collaboration and integrated service delivery for pregnant women, children and families

Aim. This paper explores the impact of models of integrated services for pregnant women, children and families and the nature of collaboration between midwives, child and family health nurses and general practitioners. Background. Increasingly, maternity and child health services are establishing integrated service models to meet the needs of pregnant women, children and families particularly those vulnerable to poor outcomes. Little is known about the nature of collaboration between professionals or the impact of service integration across universal health services. Design. Discursive paper. Methods. A literature search was conducted using a range of databases and combinations of relevant keywords to identify papers reporting the process, and/or outcomes of collaboration and integrated models of care. Results. There is limited literature describing models of collaboration or reporting outcomes. Several whole-of-government and community-based integrated service models have been trialled with varying success. Effective communication mechanisms and professional relationships and boundaries are key concerns. Liaison positions, multidisciplinary teams and service co-location have been adopted to communicate information, facilitate transition of care from one service or professional to another and to build working relationships. Conclusions. Currently, collaboration between universal health services predominantly reflects initiatives to move services from the level of coexistence to models of cooperation and coordination. Relevance to clinical practice. Integrated service models are changing the way professionals are working. Collaboration requires knowledge of the roles and responsibilities of colleagues and skill in communicating effectively with a diverse range of professionals to establish care pathways with referral and feedback mechanisms that generate collegial respect and trust.