Skip to main content

Table 2 Implementation activities to improve care for women during and after a pregnancy complicated by hyperglycaemia

From: Improving systems of care during and after a pregnancy complicated by hyperglycaemia: A protocol for a complex health systems intervention

Activity Models of Care Components TDF Domain Procedure Materials Delivered by Mode of delivery Region (TE, CA, FNQ, All)
Education for healthcare providers 1, 2, 3, 4 Knowledge; professional role; beliefs about consequences; beliefs about capabilities Develop an education calendar across each region to plan and deliver educational activities to healthcare practitioners, aligning with educational activities of other regional healthcare organisations (e.g. primary care networks) where possible, with invitation of healthcare providers through healthcare networks
Selected sessions will be recorded and delivered online to enable access for practitioners unable to attend, with information for access distributed and promoted through Partnership networks and health practitioner organisations
Newsletters to be distributed to healthcare providers and stakeholders through Partnership networks
Annual symposium, with healthcare providers and other stakeholders invited through Partnership networks
Presentations, Newsletters, Workshops, Online resources (videos, podcasts) Educational materials, including presentations and text-based materials, will be developed by project staff, with input from clinical experts (endocrinologists, diabetes nurse practitioner and educators, primary care practitioners) and Indigenous reference group
Education sessions delivered by clinicians and project staff
Face-to-face
Online
Email
Teleconference
All
Postpartum care plans and reminders 2, 3, 5 Memory, attention, decision-making Develop postpartum care plans and reminders to align with and bridge to existing Chronic Disease Care Plan after pregnancy and embed within primary healthcare electronic health record, to prompt healthcare provider recall of women at recommended timepoints for review based on guidelines Electronic primary care health record Implementation team in collaboration with health services staff, with input from clinical reference group Electronic primary care health record TE, CA
Preconception care plans 2, 3, 5 Memory, attention, decision-making Develop pre-conception care plans and embed within primary healthcare electronic health record, to prompt healthcare provider to ensure recommended pre-conception care is delivered to women with pre-existing diabetes based on guidelines Electronic primary care health record PhD student with input from clinical reference group Electronic primary care health record CA
Indigenous reference group 2, 3 Social influences Form an Indigenous reference group to provide input regarding priority-setting, resource development and implementation, by inviting Indigenous women with an interest in hyperglycaemia in pregnancy, meeting three times per year and feeding back to investigators and project staff Advice from Director of Aboriginal Programs, Menzies School of Health Research Coordinated by Indigenous implementation team member Face-to-face, with email communication between meetings TE, CA
Clinical reference group 2, 3 Social influences; motivation and goals Ongoing facilitation of a reference group of clinicians to provide input regarding priority-setting, resource development and implementation, by inviting interested clinicians through Partnership networks, to meet annually and feed back to investigators and project staff Presentations; meetings; circulation of documents/ resources for comment Coordinated by implementation team Face-to-face, with clinicians provided with email address to provide feedback between meetings TE, CA
Working group 2, 3 Social influences; motivation and goals Form a working group with representatives from partner organisations to provide input regarding priority-setting, resource development and implementation, as well as opportunity for promotion of educational opportunities Presentations; meetings; circulation of documents/ resources for comment Coordinated by implementation team Face-to-face meetings alternate months FNQ
Resource development 1, 2, 3 Environmental context and resources Development of culturally appropriate resources to assist healthcare providers in discussions with women about health after a pregnancy complicated by diabetes Postpartum discharge brochure Discharge brochure developed by implementation team with input from clinical experts Paper-based All
Aggregate DIP Clinical Register reports 1, 3, 5 Knowledge; motivation and goals Produce de-identified aggregate postpartum reports from the DIP Clinical Register six-monthly distribute to healthcare providers and stakeholders to enable quality improvement activities DIP Clinical Register Implementation team Email All
Local DIP Clinical Register reports 1, 3, 5 Memory, attention, decision-making Produce local postpartum reports with identifiable data from the DIP Clinical Register six-monthly and distribute to healthcare providers to aid in quality improvement activities and recall of women DIP Clinical Register Implementation team Email TE, CA
Modified discharge summaries 3, 5 Memory, attention, decision-making Review and amend current discharge summary templates for discharge from hospital after delivery, to include options and prompts to facilitate communication of follow-up plans between hospital and primary care providers Discharge summaries Implementation team Within electronic discharge summary TE, CA
Postpartum summary 3, 5 Memory, attention, decision-making Generate postpartum diabetes in pregnancy summary using DIP Clinical Register data and distribute to healthcare providers, including reminder for postpartum screening DIP Clinical Register Implementation team Letter FNQ
Postpartum screening reminder letters 3, 5 Memory, attention, decision-making Generate letters to healthcare providers using DIP Clinical Register data to prompt recall of women for recommended postpartum glucose check if check not recorded within six months postpartum DIP Clinical Register Implementation team Letter FNQ
Promotion of postpartum guidelines by champions 1, 4 Social influences Champions identified through engagement with Partnership activities, and upskilled regarding use of local guidelines through Partnership educational activities and publications Local clinical guidelines – CARPA (CA, TE), QCG (FNQ) Implementation team Face-to-face, email All
  1. Models of Care Components: 1 – Increasing workforce capacity, skills and knowledge and improvement in the health literacy of health professionals and women; 2 – Improving access to culturally and clinically appropriate healthcare; 3 – Improving information management and communication; 4 – Enhancing policy and guidelines; 5 – Embedding the Diabetes in Pregnancy Clinical Register as a component with the Models of Care
  2. Abbreviations: CA Central Australia, CARPA Central Australian Rural Practitioners Association (2017), DIP Diabetes in Pregnancy, FNQ Far North Queensland, QCG Queensland Clinical Guidelines (2015), TDF Theoretical Domain Framework, TE Top End, the Partnership – Diabetes Across the Lifecourse: Northern Australia Partnership