GRADUATION BITTERWSEET FOR GGT UDRH RESEARCHER Graduation from her PhD studies has been a bittersweet experience for former Camperdown doctor Ruth Stewart. On the one hand the Greater Green Triangle University Department of Rural Health (GGT UDRH) researcher feels proud that her research into the Corangamite Managed Clinical Network has been accepted and praised. On the other hand she remains frustrated that the network never continued beyond 2008 despite meeting all its targets. Dr Stewart, who now lives in Mareeba in Far North Queensland, enrolled for her PhD through the GGT UDRH and graduated on Tuesday from Flinders University. Her study examined the Corangamite Managed Clinical Network that was set up between the Camperdown, Timboon and Terang hospital maternity services from 2004 to 2008. The network drew together people and services from the three maternity services to put in place educational, quality assurance and workforce planning controls. It was inspired by a Scottish-based model recommended by GGT UDRH Director Professor James Dunbar. The Timboon and Terang hospitals committed to continuing the network, however, South West Healthcare, which manages the Camperdown hospital, declined to contribute the additional $15,000 needed to keep it running. Dr Stewart had initially planned to evaluate the outcomes of the network for her PhD but was forced to change midstream when it folded and instead investigated what happened during its time and eventual demise. She remains adamant that the network was a good investment that helped to secure ongoing maternity services for the small hospitals. “When you look around Victoria there are a lot of other services that closed. The services in Camperdown, Timboon and Terang are quite small but they are still open,” she said. “During the course of the network we went from 10 GP obstetricians to four and those services were still able to continue. Before the education and workforce planning they all would have had to close because the model of care needed a doctor to be there for all deliveries.” Dr Stewart said her research included interviews, a clinical audit of literature and participant observation, and had shown the network had been a resounding success. The network engendered a strong sense of teamwork and engagement, and promoted learning and shared clinical guidelines. “We were a learning organisation that was receptive to innovation. We reflected on our practices and changed to make improvements based on evidence. That’s a really significant achievement,” Dr Stewart said. During the life of the network midwives up-skilled from needing a doctor to attend every delivery to having the skills to perform a normal delivery without the assistance of a doctor. The education was team-based and locally delivered. “The doctors and the midwives all trained together, which was important,” Dr Stewart said. “Until that time, doctors and midwives would train separately but when you’re delivering a service, you work in teams so it makes a lot of sense to be trained in that team.” Despite the successes, Dr Stewart admits she and the steering committee were “gutted” when the network could not secure ongoing funding. “We did all the things we aimed to do but we didn’t secure ongoing funding. The two small hospitals weren’t going to fund what Warrnambool wouldn’t. We needed a supportive system and it didn’t align with Warrnambool’s interests for the network to continue.” “It was very distressing and demoralising.” However, five years later her academic study has been worthwhile. “I found it really interesting to draw together all the information; there were things when you’re in the midst of it that you don’t really see.” “The network more than achieved every aim had demonstrated that a network could be set up in small rural maternity services and then be innovative and bring in changes. It is easy to talk about things that need to be changed actually bringing about change is one of the great challenges in health services. The Corangamite Managed Network managed to do that.” Despite her disappointment about the network’s demise, Dr Stewart says the model would work in other circumstances with the right support and that her research will help others. She is now writing journal articles so others can learn from the experiences surrounding the network development and demise. “What happened for us will at least inform the next group of people who want to set up a managed clinical network. It could be replicated in other areas, and not necessarily just in maternity services. What we did won’t be in vain,” she said. The PhD has also inspired Dr Stewart, 54, to continue her research. She admits she wasn’t interested in “laboratory” research after moving into general practice in Camperdown, where she lived for more than 20 years. However, she is now involved in research programs in rural and remote Queensland and is keen to participate in more action research. “It really set me off on a journey of discovery,” she said.
Posted on: Sun, 26 Jan 2014 10:05:34 +0000
Trending Topics
Recently Viewed Topics
© 2015