Re-defining Antenatal Care - development and implementation of IMAP in a Large Tertiary Referral Maternity Service

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      Initial Maternity Assessment and Planning – IMAP
      The staged roll out of a project to offer all women planning to birth at a large tertiary referral maternity service publicly funded first trimester screening had only just begun when the COVID19 pandemic hit in early 2020. What quickly became apparent was the urgent need for change in the way services were delivered and what ensued was the early implementation of First Trimester Screening Service (FTSS) and the development of policy to support the safety of our women, our staff and the wider community.
      The early implementation of the FTSS saw a number of further developments:
      • 1.
        Increased rates of reported Domestic violence and or psychosocial vulnerabilities
      • 2.
        Highlighted duplication of midwifery and obstetric assessments in the FTSS and a traditional booking in visit.
      • 3.
        Highlighted lack of information available to women regarding models of care and maternity service in general
      A clinical redesign project, Initial Maternity Assessment and Planning (IMAP) commenced in November 2020 and was implemented in November 2021. The project delivered:
      • 1.
        A universal entry into the Service via a single electronic referral
      • 2.
        Detailed patient information regarding the IMAP visit, FTS, pathways and options for models of maternity care provided prior to initial appointment
      • 3.
        IMAP visit – comprehensive, holistic, multidisciplinary screening assessment of the pregnant woman and baby in the early pregnancy period, detailed risk assessment and risk appropriate management plan and allocated model of care
      • 4.
        Elements of antenatal care, Low and high risk pathways – schedule of antenatal visits, recommended content and supporting education and resource for women and families.
      • 5.
        Focussed visits at 16-18 weeks – welcome to your model of care and 36 weeks – Review pregnancy and recommended timing, model and place of birth
      • 6.
        Comprehensive suite of educational resources accessed via QR code.
      At this stage the project evaluation is just commencing. We expect to be able to present preliminary outcomes at the conference.
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