A qualitative exploration of midwives' and ambulance clinicians' experiences working together

Background/Aims

Effective teamwork represents a significant component of high-quality maternity care. Midwives and ambulance clinicians are sometimes required to work together in the pre-hospital setting, but these interactions are not well documented or understood. This study aimed to explore the views and experiences of clinicians, to describe the barriers to and facilitators of effective teamwork in this context.

Methods

Focus group discussions and in-depth interviews were conducted with 30 London-based clinicians who had experience of providing emergency maternity care in the pre-hospital setting as part of a multidisciplinary team. Data were analysed thematically, informed by principles of grounded theory.

Results

Three overarching themes emerged: significance of the patient environment, reaching a shared mental model and interpersonal dynamics. Challenges included conflicting priorities and lack of understanding each other's roles and skillsets. Civility and multidisciplinary training were perceived as conducive to effective teamwork.

Conclusions

The findings provide insight to the factors that were perceived to impact teamwork in a pre-hospital maternity context. Actions to improve patient safety include increased partnership working between acute and ambulance trusts, including the provision of multidisciplinary training.

Implications for practice

Midwives and ambulance clinicians report a shared goal of a safe and positive experience for the families in their care. When working towards these outcomes, teams require leadership that acknowledges the various professional remits present.