www.education.vic.gov.au/ ecsmanagement/mch/policy/default.htm Maternal and Child Health Service Maternal and Child Health Service Program Standards Maternal and Child Health Service Maternal and Child Health Service Program Standards Victorian Maternal and Child Health Service2 Published by the Programs and Partnerships Division Office for Children and Portfolio Coordination Department of Education and Early Childhood Development Melbourne Published October 2009 ISBN 978-0-7594-0582-0 © State of Victoria 2009 The copyright in this document is owned by the State of Victoria. No part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968, NEALS (see below) or with permission. An educational institution situated in Australia which is not conducted for profit, or a body responsible for administering such an institution, may copy and communicate the materials, other than third-party materials, for the educational purposes of the institution. Authorised by the Department of Education and Early Childhood Development, 2 Treasury Place, East Melbourne, Victoria 3002. Also published on http://www.education.vic.gov.au Terms and definitions 3 1 Introduction 6 1.1 Maternal and Child Health Service: Vision, mission, goals and principles 1.2 Overview of Maternal and Child Health Service 8 2 Background 10 2.1 An evidence-based framework 2.2 Structure of the Program Standards 11 2.3 Purpose and use of the Program Standards 12 2.4 Assessment against the Program Standards 3 The Maternal and Child Health Service Program Standards 13 Standard 1: Universal access Standard 2: Optimal health and development 20 Standard 3: Partnerships and collaboration 28 Standard 4: Competent and professional workforce 33 Standard 5: Responsive and accountable service delivery 43 Standard 6: Quality and safety 51 References 61 Appendix A: Development of Maternal and Child Health Program Standards 67 Appendix B: List of evidence 74 Contents Victorian Maternal and Child Health Service 79 • Audit of referrals made to Maternal and Child Health Service, including: – reason for referral – information on organisation/provider making the referral – quality of information provided within the referral. Example surveys The following are a list of example surveys, and content within the surveys, that may be utilised in order to inform the Maternal and Child Health Service on the achievement of the criteria within the Program Standards. • Survey of families, including views and feedback on: – Maternal and Child Health Service in general – access to the Maternal and Child Health Service – information available on the Maternal and Child Health Service – culturally competent service delivery for families – partnership approach to service delivery. • Survey of services which Maternal and Child Health Service offers referrals to, including views and feedback on: – appropriateness of referral – quality of information within the referral – other relevant information to improve referrals from the Maternal and Child Health Service. • Environmental survey, including: – review of accessibility of the Maternal and Child Health Service by children and families – risk assessment of environment in relation to children and families and the maternal and child health workforce. Other suggested evaluations and activities The following additional evaluations and activities are suggested in order to inform the Maternal and Child Health Service on the achievement of the criteria within the Program Standards: • Evaluation of health promotion activities undertaken by the Maternal and Child Health Service • Evaluation of key performance indicators associated with the strategic and operational plans • Review of activities to strengthen community capacity. Victorian Maternal and Child Health Service 3 Within the Maternal and Child Health Program Standards, the following terms and definitions are used: Clinical risk management – a method for identifying circumstances within the Maternal and Child Health Service that place, or potentially place, children and families at harm or at risk of harm, and addressing these circumstances to prevent or control the risk. Clinical supervision – a support mechanism for maternal and child health nurses within which service delivery, organisational, developmental and emotional experiences are shared in a secure and confidential environment in order to enhance skills and knowledge. 1 Collaborate/collaboration – to work together, with other members of the Maternal and Child Health Service, and/or other services and organisations and/or with the mother and family to achieve unified goals so as to maximise the child’s health, wellbeing, learning, development and safety. Community capacity – the community’s ability to identify and mobilise resources to address the health and wellbeing issues of young children, and associated health and wellbeing issues of the mother and family. 2 Corporate risk management – the system by which the Maternal and Child Health Service is directed, controlled and held to account, encompassing the processes, policies and responsibilities in relation to accountability, leadership, and direction of the Service. These activities support the delivery of the Maternal and Child Health Service. 3 Cultural competence – a set of behaviours, attitudes and policies that come together to enable the Maternal and Child Health Service to work effectively in cross-cultural situations, across the spectrum of service delivery from an individual level, to integrating culture into the delivery of the Service. 4 Determinants of health – factors that determine the health status of individuals and populations. The determinants of health include: • general background factors, including culture, social cohesion • environmental factors • socioeconomic factors • knowledge and attitudes • health behaviours • psychological effects • safety factors • biomedical factors • individual makeup • individual and population health. 5, 6 Terms and definitions Victorian Maternal and Child Health Service4 Family – the family is identified by their emotional attachment with the child and their concern for the child’s health, growth and development. This may include the mother, father, adoptive mother, adoptive father, grandparent, step-parent, foster parent, siblings, partner or carer. Other family members who may also share a concern for the child are referred to as ‘the extended family’. Family-centred practice – the approach to identification and management of the child, mother and family that focuses on the strengths of each individual family. 7 Father – within the Maternal and Child Health Program Standards, refers to the birth, adoptive father or step father. Governance – a system through which the Maternal and Child Health Service is responsible and accountable, and continually improves quality and safety for children and families accessing the Service. Governance comprises clinical governance; responsibility for the safe and quality service delivery and corporate governance; and responsibility for the corporate structures supporting service delivery. 8, 9 Health – a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. 10 Incident – an event, including an accident, that resulted in, or had the potential to result in, harm to the child, or family, or a member of the maternal and child health workforce, including physical or emotional injury, ill-health or other loss. 11 Integration – an approach towards providing a service to the child and family that involves working with other members of the Maternal and Child Health Service, and/or other services and organisations. The approach is identified by an interdisciplinary team approach, with the team having a shared vision of service delivery, and each team member contributing their knowledge and skills towards a shared plan of service delivery in order to achieve the goals and outcomes for the childs family. 12 Intervention – endeavours to promote good health activity and behaviour, and to prevent or limit poor health activity or behaviour. Management and leadership – indicates positions and/or roles that do not interface with the child and family including the team leader, coordinator, and other positions and structures that provide a line of accountability and reporting for the Maternal and Child Health Service. These positions have the responsibility to lead and organise the Service so as to provide a quality and safe service within the resources available to it. Victorian Maternal and Child Health Service 5 Maternal and child health workforce – the workforce that provides or assists and supports the provision of the Maternal and Child Health Service and includes maternal and child health nurses, coordinators, team leaders, clerical and other maternal and child health workers of disciplines other than nursing involved in the delivery of the Service and/or management of it. Maternal and Child Health Service – a universal health service for children from birth to school age and their families focusing on promotion of health and development, prevention, early detection of, and intervention for physical, emotional and social factors affecting young children and their families. Within the Program Standards, the Service encompasses the maternal and child health workforce, including management structures supporting the maternal and child health workforce (for example, local government or the governing authority), and areas that may support the delivery of the Service (for example, Human Resources). Monitoring – the processes of screening and assessment undertaken by the Maternal and Child Health Service. Mother – within the Maternal and Child Health Program Standards, refers to the birth mother or adoptive mother. Aspects of the Program Standards have particular relevance to physiological and psychological aspects of childbirth and therefore will be relevant only to birth mothers. Partnership – the relationship the Maternal and Child Health Service has with the child’s family or another service/organisation involved with the child. The relationship is characterised by mutual cooperation, collaboration, respect and responsibility in order to maximise the child’s development and the family’s health, safety and wellbeing. Setting – the surrounds in which the Maternal and Child Health Service is delivered. This may include, but not be limited to, the centre; within a child’s, mother’s or other family member’s home; over the telephone; as part of other health services or organisations; within groups; and in local facilities and buildings. Support – indicates the provision of information, advice, education, counselling and other relevant activities by the maternal and child health workforce to the family. Universal access – the capacity of all children and families to have equal opportunity to access the Maternal and Child Health Service. Vulnerable child, mother and family – the child and/or mother and family may be at risk of adverse health and wellbeing outcomes due to individual, parental or family circumstances. Victorian Maternal and Child Health Service6 The Victorian Maternal and Child Health Service is an integral component of a comprehensive system of child and family services in Victoria. The Service provides a universal health service for children from birth to school age, focusing on promotion of health and development, prevention, early detection and intervention for physical, emotional and social factors affecting young children. The Service consists of the Universal Maternal and Child Health Service, Enhanced Maternal and Child Health Service and the Maternal and Child Health Line. While the Service is primarily for the child, it also focuses on the health and wellbeing of the mother, and the family, in the context of the child’s health and wellbeing. The Maternal and Child Health Service is provided in partnership between local government authorities and the Department of Education and Early Childhood Development (DEECD). The Maternal and Child Health Line is funded and provided by DEECD. 1.1 Maternal and Child Health Service: Vision, mission, goals and principles The Maternal and Child Health Service Program Standards support the vision, mission, goals and principles of the Service as stated in the Maternal and Child Health Service Program Resource Guide. 7 1.1.1 Vision All Victorian children and their families will have the opportunity to optimise their health, development and wellbeing during the period of a child’s life from birth to school age. 1.1.2 Mission The mission of the Maternal and Child Health Service is to engage with all families in Victoria with children from birth to school age; to take into account their strengths and vulnerabilities; and to provide timely contact and ongoing primary health care in order to improve their health, development and wellbeing. 1.1.3 Goals The framework for the provision of the Maternal and Child Health Service is guided by an overarching goal: To promote healthy outcomes for children and their families, providing a comprehensive and focused approach to managing the physical, emotional or social factors affecting families in contemporary communities. 1 Introduction Victorian Maternal and Child Health Service 7 Two further objectives support this goal. These are to: • enhance family capacity to support young children and address physical, emotional, social and wellbeing issues affecting young children • enhance community capacity to support young children and their families to address physical, emotional, social and wellbeing issues affecting young children. 1.1.4 Principles The guiding principles for the Maternal and Child Health Service, as stated in the Maternal and Child Health Service Program Resource Guide 7 are: 1. Consultation and participation – Consultation with, and participation by, families is integral to the services. Services will be informed by, and seek to meet, the needs of young children and their families. 2. Access and availability – All families with young children should be able to readily access the information, services and resources that are appropriate for, and useful to, them. 3. Primacy of prevention – Prevention of harm or damage is preferable to repairing it later. Early detection of risk factors is required, and intervention, where appropriate. 4. Capacity building – Promotion of resilience and capacity is preferable to allowing problems to undermine health or autonomy. 5. Equity – All children should be able to grow up actively learning, healthy, sociable and safe – irrespective of their family circumstances and background. 6. Family-centred – The identification and management of child and family needs requires a family-centred approach that focuses on strengths. 7. Diversity – The diversity of Victorian families should be recognised and valued. 8. Inclusion – Inclusive practices are essential for all children to get the best start, irrespective of their family circumstances, differing abilities and background. 9. Partnership – Quality services are achieved through integrated service delivery and partnerships with other early childhood and specialist services, and with families. 10. Quality – All families with young children must be confident of the quality of information, services and resources provided to them. Victorian Maternal and Child Health Service8 11. Evidence and knowledge – Policies, programs and practice are based on the best evidence and knowledge available. 12. Evolution of services – Programs and services will continue to evolve to meet needs in a changing environment. 13. Continuously improving and adding value to services – Sustained and improved services for families and children promote better outcomes for children and their families. 7 1.2 Overview of Maternal and Child Health Service The Maternal and Child Health Service delivers a universal health service through three service components: • Universal Maternal and Child Health Service • Enhanced Maternal and Child Health • Maternal and Child Health Line. 1.2.1 Universal Maternal and Child Health Service The Universal Maternal and Child Health Service supports families and their children in the areas of parenting, development and assessment, promotion of health and development, wellbeing and safety, social supports, referrals and links with communities. The Universal Maternal and Child Health Service consists of the Key Ages and Stages consultations and a flexible service component. The Key Ages and Stages consultations provide 10 consultations, including an initial home visit and consultations at 2 weeks, 4 weeks, 8 weeks, 4 months, 8 months, 12 months, 18 months, 2 years and 3.5 years. The flexible service component allows additional needs of the child and family to be met through a range of activities, including first-time parent groups, additional consultations, telephone consultations and community strengthening activities. Victorian Maternal and Child Health Service 9 1.2.2 Enhanced Maternal and Child Health Service The Enhanced Maternal and Child Health Service focuses on children, mothers and families at risk of poor health and wellbeing outcomes, in particular where multiple risk factors for poor outcomes are present. The Enhanced Maternal and Child Health Service is provided in addition to the suite of services offered through the Universal Maternal and Child Health Service. The Enhanced Maternal and Child Health Service provides a more intensive level of support, including short-term case management in some circumstances. Support may be provided in a variety of settings, including the family home, the maternal and child health centre, or other locations within the community. 1.2.3 Maternal and Child Health Line The Maternal and Child Health Line is a 24-hour telephone line providing appropriate information, advice, support, counselling and referral to families with children from birth to school age. The Line also links families to the Universal Maternal and Child Health Service and other community, health and support services required for optimal health and wellbeing of the child, mother and family. The Line does not provide an emergency service. Victorian Maternal and Child Health Service10 2.1 An evidence-based framework The Maternal and Child Health Program Standards provide an evidence-based framework for the consistent, safe and quality delivery of the Maternal and Child Health Service. The Program Standards support the provision of clinical and corporate governance within the Service, and provide a systematic approach to improving service delivery and safety. The key elements supported by the Program Standards being: • accountability • continuous improvement • workforce competence • performance development • clinical effectiveness • evidence-based practice • risk management • child and family safety • service delivery • performance review • dealing with complaints • safety of the workforce • data and information management • leadership and governance • community engagement. 3 2 Background [...]... education a) The Maternal and Child Health Service supports performance development of the maternal and child health workforce b) The Maternal and Child Health Service has a learning and development system to support a competent maternal and child health workforce 34 Victorian Maternal and Child Health Service Standard 4 – The Maternal and Child Health Service is delivered by a competent and professional... Responsive service delivery a) The Maternal and Child Health Service is relevant and responsive to the needs of the child and family in service delivery and setting b) The vulnerable child, mother and family are identified and supported to engage with appropriate services, including the Enhanced Maternal and Child Health Service c) The Maternal and Child Health Service identifies and responds to the child. .. delivery of the Maternal and Child Health Service b) The recruitment processes for the Maternal and Child Health Service support a competent and professional maternal and child health workforce c) Human resource planning identifies and responds to the current and future Maternal and Child Health Service workforce’s needs for the Maternal and Child Health Service 3 Performance development and continuing... feedback on service delivery and service improvement activities The Service is encouraged to use the Program Standards to self-assess in order to improve service quality, and to incorporate review of the Program Standards as part of routine service review 12 Victorian Maternal and Child Health Service 3 The Maternal and Child Health Service Program Standards 1 The Maternal and Child Health Service provides... paper * • survey of services to whom Maternal and Child Health Service refers Victorian Maternal and Child Health Service 31 Standard 3 – The Maternal and Child Health Service builds partnerships with families and communities and collaborates and integrates with other services and organisations Criteria element Performance criteria Examples of evidence b) The Maternal and Child Health Service collaborates... Enhanced Maternal and Child Health Service • The Maternal and Child Health Service has processes to identify the vulnerable child, mother and family • policy/process of identification; associated service delivery/referral; and engagement of vulnerable children, mothers and families • The Maternal and Child Health Service identifies and removes barriers for access to services by the vulnerable child, ... development and safety b) The Maternal and Child Health Service optimises the child s health, wellbeing, learning, development and safety by recognising and acknowledging the determinants of health 20 Victorian Maternal and Child Health Service c) The Maternal and Child Health Service utilises validated tools and assessments to optimise the child s health, wellbeing, learning, development and safety d) The Maternal. .. for their child • The Maternal and Child Health Service uses a range of strategies to support mothers and families to develop skills and abilities to make decisions about the child s growth and development and the family’s health, safety and wellbeing Victorian Maternal and Child Health Service Standard 3 – The Maternal and Child Health Service builds partnerships with families and communities and collaborates... Victorian Maternal and Child Health Service 35 Standard 4 – The Maternal and Child Health Service is delivered by a competent and professional workforce Criteria element Performance criteria Examples of evidence b) The maternal and child health nurses maintain the requirements of their registration • The maternal and child health nurses working within the Maternal and Child Health Service comply with and/ or... Examples of evidence b) The vulnerable child, mother and family are identified and supported to engage with appropriate services, including the Enhanced Maternal and Child Health Service • The Maternal and Child Health Service schedules and promotes additional support for the vulnerable child, mother and family through the Enhanced Maternal and Child Health Service (see Standard 1 Criterion 2b) • number of . www.education.vic.gov.au/ ecsmanagement/mch/policy/default.htm Maternal and Child Health Service Maternal and Child Health Service Program Standards Maternal and Child Health Service Maternal and Child Health Service. Maternal and Child Health Service – Maternal and Child Health Line, or – Enhanced Maternal and Child Health Service. • The Maternal and Child Health Service