Shared maternity care: all care – not enough responsibility? An audit of patient care communications pre- and post- a multi-faceted intervention


: Dr Susan Nicolson, Department of General Practice, University of Melbourne 200 Berkeley St, Carlton, Victoria 3053, Australia. Email:


Background:  Shared maternity care is an important model of care in Australia and overseas, but Victorian studies have shown patient dissatisfaction and widespread communication problems.

Aims:  This study aimed to implement and evaluate initiatives to improve communication between three maternity hospitals and general practitioners involved in shared maternity care in Melbourne.

Methods:  A pre- and post-design with audit of 150 hospital records at each of three hospitals plus audit of 20 general practitioner files for evidence of key communications on shared care patients, before and after a multifaceted intervention.

Results:  Significant improvements at individual hospitals were seen if one person was made responsible for a communication outcome. Other initiatives did not lead to improvements if they did not include individual accountability.

Conclusion:  The standard of integration of shared maternity care is unacceptable low. Improvements to communication are achievable but depend on the allocation of individual time and responsibility, plus a commitment by hospitals to ongoing audit of their performance.