Addressing the workplace needs of Western Australian midwives: a Delphi study

Abstract

Objective. To determine the workplace needs of Western Australian midwives working in public metropolitan secondary hospitals. Method. Using a three-round Delphi approach, Round 1 incorporated focus groups and a questionnaire. Fifteen focus groups were conducted with midwives also having the option of contributing through an open-ended questionnaire. During Round 2, 38 items reflecting seven themes were prioritised with a final ranking performed in Round 3. In total, 114 midwives participated in Round 1, 72 in Round 2 and 89 in Round 3. Results. During Round 1, workplace needs identified as being met included: working across all areas of midwifery; ability to work in areas of interest; opportunity to work with low to moderate risk women; supportive colleagues; accessible parking; hospital close to home and friendly work atmosphere. Round 2 items revealed the five top unmet needs as: adequate midwifery staff coverage; access to maintained equipment; competitive pay scales; patient safety issues and opportunities to implement midwifery models. The top ranked needs from Round 3 included: recognising the unpredictable nature of midwifery services; provision of competent medical coverage, and adequate midwifery staff coverage. Conclusions. Demand for maternity services is unpredictable; however, in order to maintain a sustainable maternity workforce, WA midwives’ prioritised needs would suggest health management focus upon expanding the availability of midwifery models of care, fostering flexible working conditions and ensuring collaboration between maternity health professionals occurs within clinically safe staffing levels. What is known about the topic? Dissatisfaction with working conditions, staff shortages, and feeling undervalued or unsupported contribute to healthcare workforce attrition. However, positive practice environments and health service management and leadership can influence employee satisfaction and retention. What does this paper add? These insights into Western Australian midwives’ met and unmet needs within the context of public metropolitan secondary units provide a more practical basis for the revision of work conditions than has been reported previously. What are the implications for practitioners? Our findings reinforce the urgent need to address the midwifery workforce priorities highlighted in the Australian National Maternity Services Plan. Specifically, this study strongly underscores the requirement to expand the availability of midwifery models of care, foster flexible working conditions and ensure collaboration between maternity health professionals occurs within clinically safe staffing levels.