101 4 MODELS OF RISK SELECTION IN MATERNAL AND NEWBORN CARE 2022, 19, 1046 9 of 15 discussed all women who had a booking appointment in obstetrician-led care. Forty-eight (96%) MCCs started routinely planning discussions between midwives and obstetricians, and six (12%) MCCs started routinely planning multidisciplinary discussions. Two (4%) of these MCCs started with routine visits for all women to the obstetrician. Table 6. Change in the usual organization of tasks and responsibilities in risk selection (n,%). Change in the Past Decade Reversed Change Back to the Usual Model n(%) n(%) Total MCCs # 69 (100) 50 (100) * No 15 (22) 41 (82) Yes 46 (67) 9 (18) Variation within the MCC 4 (5) Contradictory answers amongst respondents within the MCC 4 (5) * Sum of ‘yes’ and ‘variations within the MCC’. # MCC = Maternity Care Collaboration. Nine (18%) MCCs of the 50 MCCs that made changes in their usual organization of tasks and responsibilities in risk selection changed back to their usual organization of tasks and responsibilities in risk selection (Table 6). Five (10%) changed back to their usual organization of tasks and responsibilities in risk selection because of time constraints or the loss of autonomy of the primary care midwives. Four (8%) MCCs changed some of the characteristics of the newly implemented MRS back to their usual organization of tasks and responsibilities in risk selection because of time constraints, financial constraints, or because the changes were experienced as unnecessary (Table S2). 3.5. Level of Satisfaction The results of the descriptive analysis of level of satisfaction for the three MRS are presented in Table S3. Overall, the respondents indicated being very satisfied. The respondents were least satisfied about their time investment (73%). Respondents from primary midwifery care practices were more often very satisfied about the quality of care (84% versus 69%), and respondents from obstetrics departments were more often very satisfied about time investment (53% versus 20%) and autonomy (81% versus 73%). Primary care midwives working in MCCs using MRS 3 were least satisfied, except for the quality of collaboration and organization of care, where those in MRS 1 and model 2 were least satisfied, respectively. Primary care midwives working in MCCs using MRS 2 were most satisfied, except for autonomy and organization of care, where those in MRS 1 and model 3 were least satisfied, respectively. Respondents from the obstetrics departments indicated the least satisfaction with the quality of care and quality of collaboration when working in MCCs using in MRS 1 and time investment and autonomy when working in MCCS using MRS 3. Respondents from obstetrics departments working in MCCs using MRS 2 indicated the most satisfaction, except for the organization of care, which the obstetrics departments working in MCCs using MRS 3 were most satisfied about. The results of the chi-square test are shown in Table 7. We found no significant difference between the MRS and levels of satisfaction. Tests for primary midwifery care practices and obstetrics departments only showed statistically significant differences for the relation between quality of care and respondents from obstetrics departments (p= 0.037, MRS 1 very satisfied 17 (47%), ‘a little satisfied’ 13 (81%), model 2 ‘very satisfied’ 13 (26%), ‘a little satisfied’ 1 (6%), model 3 ‘very satisfied’ 6 (17%), and ‘a little satisfied’ 2 (13%)).
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