Continuity of care in community midwifery

John Bowers (), Helen Cheyne (), Gillian Mould () and Miranda Page ()

Health Care Management Science, 2015, vol. 18, issue 2, 195-204

Abstract: Continuity of care is often critical in delivering high quality health care. However, it is difficult to achieve in community health care where shift patterns and a need to minimise travelling time can reduce the scope for allocating staff to patients. Community midwifery is one example of such a challenge in the National Health Service where postnatal care typically involves a series of home visits. Ideally mothers would receive all of their antenatal and postnatal care from the same midwife. Minimising the number of staff-handovers helps ensure a better relationship between mothers and midwives, and provides more opportunity for staff to identify emerging problems over a series of home visits. This study examines the allocation and routing of midwives in the community using a variant of a multiple travelling salesmen problem algorithm incorporating staff preferences to explore trade-offs between travel time and continuity of care. This algorithm was integrated in a simulation to assess the additional effect of staff availability due to shift patterns and part-time working. The results indicate that continuity of care can be achieved with relatively small increases in travel time. However, shift patterns are problematic: perfect continuity of care is impractical but if there is a degree of flexibility in the visit schedule, reasonable continuity is feasible. Copyright Springer Science+Business Media New York 2015

Keywords: Home health care; Staff scheduling; Routing; Simulation (search for similar items in EconPapers)
Date: 2015
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Citations: View citations in EconPapers (12)

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DOI: 10.1007/s10729-014-9285-z

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