Hôpital Montfort's Postnatal Care-at-Home Program: An Innovative Model for Early Postnatal Care.

The Montfort Postnatal Care-at-Home (MPCH) Program is an innovative, integrated physician, nurse and midwifery model of care that offers an early hospital discharge option to families. The MPCH Program provides care and support to families throughout their transition from hospital to home. The program has the potential to improve families' experiences and maternal-newborn health outcomes, and provides a safety net to families 24/7 during the first seven days postpartum at home. This model transforms how postnatal care is delivered, and has the potential to improve the flow of the birthing unit and the unit capacity and reduce acute care hospital costs.

[Barriers to and facilitators for using a risk assessment tool to prevent violent behaviour in patients with mental health conditions: Perspectives of health care providers]. / Les obstacles et les facilitateurs à l'utilisation de l'évaluation du risque de violence auprès des personnes ayant des troubles mentaux : perceptions du personnel soignant.

Regular assessment of risk of violence is shown to be effective in reducing violence in mental health services. PURPOSE: To evaluate health care providers' use of a violence risk assessment tool on a mental health unit and the facilitators for and barriers to its use. METHODS: A descriptive study using the Dillman approach and informed by the Knowledge to Action framework was conducted. RESULTS: Twenty-six health care providers responded to the survey; 62% reported using the violence risk assessment tool available on their unit, but not on a daily basis. Common barriers were lack of knowledge of the tool, lack of resources and time, and negative attitudes toward patients. 42% of participants indicated the need for further training on violence risk assessment. CONCLUSION: Despite high exposure to violence, health professionals were not conducting daily risk assessments. The barriers and facilitators identified provide direction for interventions that are necessary if the daily use of violence risk assessment tools is to be increased.

A Dozen Strategies Along the Ten Steps Baby-Friendly Initiative Journey.

To improve the quality of care and maternal-newborn outcomes, Hôpital Montfort implemented the Registered Nurses' Association of Ontario Best Practice Guideline on Breastfeeding, which supports the Baby-Friendly Initiative (BFI). This journey was challenging yet rewarding. Overall, we report success with increased mother-infant skin-to-skin contact at birth and breastfeeding immediately postpartum. However, challenges with formula supplementation rates continue. This paper discusses 12 strategies that emerged from lessons learned and provides links to our policies and patient education materials. The information may be helpful to others, as implementation of parts of the BFI are inserted in criteria for the Canadian accreditation.

Psychometric Testing of the French Language Quality of Prenatal Care Questionnaire.

BACKGROUND AND PURPOSE: To assess the psychometrics of the French language Quality of Prenatal Care Questionnaire (QPCQ). METHODS: Data from 302 women were used in a confirmatory factor analysis and in assessment of construct validity through hypothesis testing and internal consistency reliability using Cronbach's alpha. RESULTS: The 6 factors (subscales) were verified and confirmed. Hypothesis testing further supported construct validity. The overall QPCQ had acceptable internal consistency reliability (Cronbach's alpha = .97) as did 5 subscales (Cronbach's alpha = .70-.92); the Sufficient Time subscale had poorer reliability (Cronbach's alpha = .61). CONCLUSIONS: The French language QPCQ is a valid and reliable self-report measure of prenatal care quality. It can be used in research and in quality improvement work to strengthen prenatal care services.

Program evaluation of hospital-based antenatal home care for high-risk women.

In light of the emphasis on increased efficiency in the delivery of hospital-based healthcare services in Canada, healthcare administrators need to advocate for greater care in the community. The implementation of an antenatal home-care program for women with high-risk pregnancies at the Ottawa Hospital presented the opportunity to develop a comprehensive framework to evaluate the value and outcomes of the new community-based program.