Maternal and Child Health Service. Program Standards

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www.education.vic.gov.au/

ecsmanagement/mch/policy/default.htm

Maternal and Child

Health Service

Maternal and Child Health Service

Program Standards

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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

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

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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.

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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.

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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.

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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 Guide7_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.

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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.

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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.

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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

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2.2 Structure of the Program Standards

There are six Maternal and Child Health Program Standards. Each Standard has four components:

1. Statement of rationale – outlines why the Standard has been included.

2. Criteria – each criterion contains a number of elements outlining how the Service demonstrates compliance with, and performance relevant to, the standard.

3. Performance criteria – strategies, procedures and processes that need to be in place to meet the criteria.

4. Examples of evidence – examples of how the criteria may be met.

The six standards are not mutually exclusive. Elements of each standard and the underlying criteria within the standards are closely linked, as demonstrated in Figure 1.

Standard Three

Standard Four

Standard One

Standard Five

Standard Two

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2.3 Purpose and use of the Program

Standards

The purpose of the Program Standards is to guide and support the Maternal and Child Health Service in service delivery. The Program Standards are applicable to, and recommended for use by the maternal and child health workforce and support structures for service provision, including local government or the governing authority and the Department of Education and Early Childhood Development (DEECD). The evidence for the criteria are examples only, and not mandatory. The examples provide guidance on appropriate evidence to support attainment of the criteria. The list of evidence is not exhaustive, and users of the Program Standards are encouraged to explore other ways of providing evidence to demonstrate compliance with the Program Standards (in addition to the listed evidence provided). Examples of good practice, and resources and tools to assist with implementation of the Program Standards are located in Appendix B.

Note: Due to the operational environment and scope of services provided by the Maternal and Child Health Line, certain performance criteria or achievement of performance criteria are not applicable. Where this is the case, an asterisk (*) has been placed next to the relevant performance criteria or achievement of performance criteria. When the asterisk (*) appears under a criterion element, all listed performance criteria are deemed not applicable to the Maternal and Child Health Line.

2.4 Assessment against the Program

Standards

As described , the Program Standards are designed to support and promote evidence-based practice or best practice within the Maternal and Child Health Service. The Program Standards have been developed to encourage and support the Service to maintain and improve service quality, standardise service delivery and support measurement to provide 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.

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1. The Maternal and Child Health Service provides universal access to its services for Victorian children from birth to school age and their families.

2. The Maternal and Child Health Service promotes optimal health and

development outcomes for children from birth to school age through a focus on the child, mother and family.

3. The Maternal and Child Health Service builds partnerships with families and communities and collaborates and integrates with other services and organisations.

4. The Maternal and Child Health Service is delivered by a competent and professional workforce.

5. The Maternal and Child Health Service, supported by local government or the governing authority, provides a responsive and accountable service for the child, mother and family through effective governance and management.

6. The Maternal and Child Health Service delivers a quality and safe service.

Rationale

The early years of a child’s life provide a critical opportunity to give a child the best start in life, in order to achieve optimal health, development and wellbeing. There are a large number of risk factors associated with these years that have negative impacts on the child’s health, developmental, learning and social outcomes. Conversely, there are a large number of protective factors in early childhood that are associated with prevention of adverse events for the child’s health, developmental, learning and social wellbeing.13_{Evidence suggests that action taken to reduce risk, and to develop} protective factors, provides the foundation for cognitive, coping and emotional skills that positively affect learning, behaviour and health throughout life.14

Through the delivery of a universal Maternal and Child Health Service for children in Victoria, the Service plays a unique and integral part in reducing the risk factors and increasing the protective factors for adverse outcomes for children. In order to do this,

3 The Maternal and Child Health

Service Program Standards

Standard 1:

Universal access

The Maternal and Child Health Service provides universal access to its services for Victorian children from birth to school age, their mothers and families.

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Criteria for Standard 1

1. Universal access and participation 2. Responsive service delivery

3. Culturally competent service delivery 1. Universal access and participation

a) All Victorian children and families have access to, and are encouraged to engage with, the Maternal and Child Health Service from the birth of the child until the child commences school.

b) Service information supports families accessing the Maternal and Child Health Service.

2. 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 at risk of, or experiencing, neglect or abuse.

3. Culturally competent service delivery

The Maternal and Child Health Service provides a culturally competent service to the child and family, including a service appropriate for Aboriginal and Torres Strait Islander communities.

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Standard 1 – The Maternal and Child Health Service provides universal access to its services for Victorian children from birth to school age, their mothers and families

Criteria element

Performance criteria

Examples of evidence

1. Universal access and participation

a) All Victorian children and families have access to, and are encouraged to, engage with, the Maternal and Child Health Service from the birth of the child until the child commences school.

• Victorian children and families have access to: – the Universal Maternal and Child Health Service,

including the Key Ages and Stages consultations and the flexible component of the Universal Maternal and Child Health Service

– Maternal and Child Health Line if required – Enhanced Maternal and Child Health Service.

• All Birth Notifications to the Maternal and Child Health Service are responded to and families are provided with the opportunity to engage with the Service.

• The Maternal and Child Health Service provides a welcoming environment to families to encourage engagement with the Service.

• The Maternal and Child Health Service promotes regular contact between the Service and the child and family through the recommended schedule of contact in the Key Ages and Stages Framework. The recommended schedule of contact is at*: – following receipt of the Birth Notification (home visit) – two weeks

– four weeks – eight weeks – four months – eight months – twelve months

• Maternal and Child Health Service participation rates • survey of families

attending

• processes for contacting families who do not engage with the Service

(16)

Criteria element

Performance criteria

Examples of evidence

b) Service information supports families accessing the Maternal and Child Health Service.

• Information on the Maternal and Child Health Service is available on the DEECD website.

• Information on the Maternal and Child Health Service is available on the local government website /or the governing authority website.

• Written information on the Maternal and Child Health Service is available. The Maternal and Child Health Service has information available when the Service is telephoned out of hours, which includes*:

– identification of Maternal and Child Health Service – hours of operation

– where to access emergency care for the unwell child – telephone number to access the Maternal and Child

Health Line.

• information on website • website information

available in multiple languages

• number of website hits • posters containing

Maternal and Child Health Service information • out-of-hours telephone

message contains hours of operation, access for emergency care, and the MCH Line number • annual report of the

Maternal and Child Health Line

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Criteria element

Performance criteria

Examples of evidence

2. 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.

• The Maternal and Child Health Service has a flexible approach to meet individual needs of the child and family. This approach may be through:

– the Universal Maternal and Child Health Service – Maternal and Child Health Line, or

– Enhanced Maternal and Child Health Service.

• The Maternal and Child Health Service schedules, supports and promotes availability of services outside traditional working hours.

• The hours of operation for each service reflects the needs of its community and, where appropriate, includes service delivery outside of traditional working hours or on weekends.

• A range of settings and models for service delivery are offered to meet the needs of the child and family.* Examples include, but are not limited to:

– clinic setting via appointment – ‘drop in’ services

– within the home of the child, the mother or family – early childhood services

– family support organisations – play groups

– telephone.*

• Service delivery is outlined in relevant policies and procedures

• survey of families utilising service to provide service feedback

• number of enrolments from birth notifications • number of families

utilising the service outside of traditional working hours

• policies and procedures that promote services outside of traditional working hours

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Criteria element

Performance criteria

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).

• The Maternal and Child Health Service has processes to identify the vulnerable child, mother and family.

• The Maternal and Child Health Service identifies and removes barriers for access to services by the vulnerable child, mother and family.

• Service delivery provides opportunities for engagement with the vulnerable child, mother and family.

• The Maternal and Child Health Service provides, or can refer to, appropriate services to meet the needs of the vulnerable child, mother and family.

• number of families receiving the Enhanced Maternal and Child Health Service

• policy/process of identification; associated service delivery/referral; and engagement of vulnerable children, mothers and families • record of identifying barriers to access and service response • number of referrals to

Enhanced Maternal and Child Health Service and other services

c) The Maternal and Child Health Service identifies and responds to the child at risk of, or experiencing, neglect and abuse.

• The Maternal and Child Health Service identifies the child at risk of, or experiencing, neglect and abuse and acts on professional observation and judgement.

• The Maternal and Child Health Service responds to the child at risk of, or experiencing, abuse and makes notification in accordance with the Children, Youth and Families Act 2005.16

• The maternal and child health workforce is supported in forming the belief about, and responding to, child neglect and abuse by policies, procedures and training (see Standard 4 Criterion 1c).

• number of notifications made to Child Protection • evidence of knowledge

of staff

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Criteria element

Performance criteria

Examples of evidence

3. Culturally competent service delivery

The Maternal and Child Health Service provides a culturally competent service to the child and family including a service appropriate to Aboriginal and Torres Strait Islander communities.

• The Maternal and Child Health Service considers the needs of individual families and recognises cultural diversity within its service delivery.

• The Maternal and Child Health Service recognises Aboriginals and Torres Strait Islanders as the traditional owners of the land and provides a service respecting their culture.

• The workforce employed at the Maternal and Child Health Service reflects, where practicable, the cultural diversity of the local community.

• The maternal and child health workforce is provided with training in cultural competency, with a focus on training in the cultural needs of the local community.

• The maternal and child health workforce feels confident in its knowledge and skills to provide the Service to the child, mother and family from other cultures.

• The maternal and child health workforce utilises its knowledge and skills to ensure the child, mother and family feel welcome to access the Service.

• The maternal and child health workforce understands the individual interpretation of their own culture for each child, mother and family accessing the Service.

• The Maternal and Child Health Service ensures access to interpreters for mothers and families from non-English speaking backgrounds.

• Materials are developed to provide information in appropriate

• models of culturally competent services provided

• survey/feedback from families

• literature and other information in appropriate languages

• training undertaken by maternal and child health workforce

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Rationale

The early years of life are critical, and influence learning, health and behaviour throughout life. Through the use of targeted interventions in the early years, the Maternal and Child Health Service has the opportunity to influence the health, wellbeing, learning, development and safety of the child, that in turn will influence their learning, health and behaviour throughout life.17

The Service promotes optimal health and development outcomes for children through targeted service delivery;18_{a flexible approach to meet the needs of the child, mother} and family; professional judgement, and the use of validated tools and evidence-based interventions. The Service uses promotion of health and development to reduce health risks, and to increase the capacity of the mother and family, empowering them to make decisions in order to improve the health, wellbeing, learning, development and safety of the child.14, 17, 19

The health and wellbeing of the mother is a key element in influencing the health, wellbeing, development and safety of the child,20_{and is a core component of the} Maternal and Child Health Service. The unique role of the father is also recognised in the health and development of the child21, 22_{and the Service supports the father} in his role. In order to optimise outcomes, support and intervention provided by the Maternal and Child Health Service acknowledges and recognises the determinants of health4, 5_{for each child, mother and family.}

Criteria for Standard 2

1. Health and wellbeing of the child 2. Health and wellbeing of the mother 3. Role of the father

4. Role of the family

5. Service delivery based on evidence 1. Health and wellbeing of the child

a) The Maternal and Child Health Service utilises monitoring, intervention and promotion of health and development to optimise the child’s health, wellbeing, learning, 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.

Standard 2:

Optimal health and

development

The Maternal and Child Health Service promotes optimal health and development outcomes for children from birth to school age through a focus on the child, mother and family.

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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 and Child Health Service provides the family with information for

the promotion of health and development of the child.

2. Health and wellbeing of the mother

The Maternal and Child Health Service utilises monitoring, support and intervention to improve the health and wellbeing of the mother.

3. Role of the father

The Maternal and Child Health Service recognises the unique role of the father in the health and development of the child and supports him in this role.

The Maternal and Child Health Service recognises and promotes the role of the family in the health and development of the child.

5. Service delivery based on evidence

a) The Maternal and Child Health Service delivers evidence-based and/or best practice monitoring, intervention and promotion of health and development. b) The Maternal and Child Health Service promotes evidence-based service delivery

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Standard 2 – The Maternal and Child Health Service promotes optimal health and development outcomes for children from birth to school age through a focus on the child, mother and family.

Criteria element

Performance criteria

Examples of evidence

1. Health and wellbeing of the child

a) The Maternal and Child Health Service utilises monitoring, intervention and promotion of health and development to optimise the child’s health, wellbeing, learning, development and safety.

• The Maternal and Child Health Service utilises the Key Ages and Stages Framework to optimise the child’s health, wellbeing, learning, development and safety.

• The Key Ages and Stages Framework consists of three components, monitoring, evidence-based interventions and promotion of health and development.

• Professional observation and judgment are utilised and the mother’s and family’s concerns acted upon.

• Monitoring of the child is inclusive of: • Family health and wellbeing

– physical assessments, including weight, height, head circumference, hips and gait

– developmental assessment, including eliciting of parental concerns , regarding the child’s global/cognitive, social-emotional, behavioural, motor and language skills – hearing risk factors

– vision – oral health.

• Evidence-based interventions to improve outcomes for children: – smoking cessation

– optimal parental mental health

– free from child exposure to conflict or family violence – teeth cleaning

– promotion of a healthy weight – promotion of a healthy BMI.

• Promotion of health and development is targeted at priorities identified by the Maternal and Child Health Service promotion of health and development, that may include:

– safe sleeping arrangements – immunisation

– oral health – vision

– nutrition – literacy

– kindergarten enrolment

– child safety and injury prevention

– other health promotion relevant to the community (see Standard 1 Criterion 2).

• The Maternal and Child Health Service monitors the immunisation status of the child, and promotes adherence to the recommended immunisation schedule.24

• evidence of Key Ages and Stages activities undertaken

• Key Ages and Stages consultations targets are met

• headline indicators23_, including the proportion of infants exclusively breast fed at four months of age • adherence to Maternal

and Child Health Practice Guidelines

• referrals to other agencies and services

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Criteria element

Performance criteria

Examples of evidence

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.

• The Maternal and Child Health Service recognises and acknowledges the determinants of health to:

– identify factors that may affect the health and wellbeing of the child

– target service delivery

– provide social support and appropriate referrals in consultation with the mother and family (see Standard 3 Criterion 2 and Standard 1 Criterion 2).

• key performance indicators – count of reasons for counselling

c) The Maternal and Child Health Service utilises validated tools and assessments to optimise the child’s health, wellbeing, learning, development and safety.

• The Maternal and Child Health Service utilises validated tools and assessments to monitor the child’s health and wellbeing, including but not limited to:

– Parents’ Evaluation of Development Status (PEDS) – Brigance (secondary screening)

– physical assessment

– hearing risk factor assessment – Melbourne Initial Screening Test – oral health assessment.

• Appropriate referrals to support the child’s growth and development are made in consultation with the mother and family (see Standard 3 Criterion 2).

• key performance indicators – number of PEDS/

Brigance undertaken • key performance indicators

– count of number of Melbourne Initial Screening Tests completed • maternal and child health

workforce competence in undertaken assessments • number of referrals made

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Criteria element

Performance criteria

Examples of evidence

d) The Maternal and Child Health Service provides the family with information for the promotion of health and development of the child.

• The Maternal and Child Health Service provides information in accordance with the Key Ages and Stages Framework. • Professional observation and judgment are utilised when

providing the mother and family with information for the promotion of health and development of the child.

• Anticipatory guidance may be provided based on the needs of the child and family and may include information on: – attachment and parenting

– recognising serious illness in the child – play activities

– child development and/or behaviour – toilet training

– sibling rivalry – nutrition – literacy.

• Information and support provided to families are:

– based on evidence and/or best practice (see Standard 2 Criterion 3)

– appropriate and tailored to each mother and family to maximise their understanding

– provided in a culturally appropriate manner (see Standard 1 Criterion 3)

– see Standard 1 Criterion 2).

• Written information and resources prepared by the Maternal and Child Health Service are:

– clearly identified as a resource of the Maternal and Child Health Service

– contains links to websites

– reviewed annually by the Maternal and Child Health Service. • Written information not prepared by the Maternal and Child

Health Service is provided from recognised organisations or associations that are clearly identified, and are appropriate for, the child, their mother or family.

• In consultation with the mother and family, the Maternal and Child Health Service refers the mother and family to appropriate services if additional support is required

(see Standard 3 Criterion 2).

• information available on relevant topics

• information available is culturally appropriate • number of referrals for the

mother and family • review of information

annually

• evidence of information provision within health records

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Criteria element

Performance criteria

Examples of evidence

2. Health and wellbeing of the mother

The Maternal and Child Health Service utilises monitoring, support and information to improve the health and wellbeing of the mother.

• Maternal health and wellbeing are monitored at each contact with the Maternal and Child Health Service, and physical and emotional health issues for the mother are addressed. This may include:

– breastfeeding – incontinence

– post-natal depression – recovery following childbirth – adjustment to becoming a mother – family planning

– partnership relationship

– management of tiredness and fatigue – other women’s health issues.

• The health and wellbeing of the mother are reviewed in relation to the child’s health and wellbeing

• Professional observation and judgment are utilised when monitoring and assessing maternal health and wellbeing. • Appropriate referrals to support the mother’s health and

wellbeing are made in consultation with the mother (see Standard 3 Criterion 2).

• The Maternal and Child Health Service promotes and supports groups to bring mothers together for support and to promote social networks (see Standard 3 Criterion 3).

• key performance indicators – breastfeeding rates • key performance indicators

– count of reasons for referrals

• audit of referrals • adherence to Maternal

and Child Health Program Resource Guide

• four week maternal wellbeing check • knowledge of groups

within local community • provision and support

of groups within local community

(26)

Criteria element

Performance criteria

Examples of evidence

3. Role of the father

The Maternal and Child Health Service recognises the unique role of the father in the health and development of the child and supports him in this role.

• The Maternal and Child Health Service recognises the unique role the father plays in the child’s life and health and development.

• The father is provided with appropriate support in his parenting role by the Maternal and Child Health Service.

• Professional observation and judgment are utilised when supporting the father in their parenting role and in the provision of support.

• The Maternal and Child Health Service promotes and supports groups to bring fathers together for support and to foster social networks (see Standard 3 Criterion 3).

• survey to determine satisfaction of fathers with the Service

The Maternal and Child Health Service recognises and promotes the role of the family in the health and development of the child.

• The Maternal and Child Health Service promotes the role of the family in the health and development of the child. • The health and wellbeing of the family, in the context of its

relationship with the child’s health and wellbeing, is monitored at each contact made with the Maternal and Child Health Service. • Appropriate referrals to support the health and wellbeing of the

family are made in consultation with the family (see Standard 3 Criterion 2).

• The Maternal and Child Health Service promotes and supports groups to bring families together for support and to foster social networks (see Standard 3 Criterion 3).

• health record audit • audit of referrals for

the family

• knowledge of groups within local community • provision and support

of groups within local community

(27)

Criteria element

Performance criteria

Examples of evidence

5. Service delivery based on evidence

a) The Maternal and Child Health Service delivers evidence-based and/or best practice monitoring, intervention and promotion of health and development.

• The Maternal and Child Health Service implements service delivery in accordance with evidence and recommendations from relevant research.

• In the absence of evidence and/or recommendations from research, service delivery is in line with the acknowledged best practice within Maternal and Child Health.

• The maternal and child health workforce supports the implementation of best practice service delivery.

• evidence of service delivery updated in line with new evidence • adherence to Key Ages

and Stages Framework • evidence of use of

practice guidelines

b) The Maternal and Child Health Service promotes evidence-based service delivery, through the participation in and support of research.

• The Maternal and Child Health Service encourages and supports participation in research to facilitate the development of evidence for maternal and child health.

• Research undertaken in part, or in full, within the Maternal and Child Health Service has received relevant research approvals, including approval by the DEECD Early Childhood Research Committee.

• evidence of participation and contribution to research

• evidence of approval for research from the Early Childhood Research Committee

(28)

Rationale

To maximise the child’s health, wellbeing, learning, development and safety, high levels of family involvement are required. A successful Maternal and Child Health Service optimises the child’s health, wellbeing, learning, development and safety, and the wellbeing of the mother and family by adopting a family-centred approach. This approach involves the Service working in partnership with the child and family and identifying the strengths of the family. The Service also works with families to strengthen their capacity, in order to provide the child with a safe and supportive environment.25

In order to meet the needs of the child the Service collaborates and works in partnership with early years services, health services, family services, programs, and organisations. These partnerships support effective linkages and referrals between the Maternal and Child Health Service and other services, and enable the provision of cohesive service delivery when more than one service is involved with the child, mother and family. Working in partnership with other organisations and services is particularly important when providing a service for the vulnerable child.17, 26

Criteria for Standard 3

1. Working with the mother and family

2. Working with other services and organisations 3. Working with the community

1. Working with mothers and families

a) The Maternal and Child Health Service provides child-focused, family-centred practice, working in partnership with the child and family.

b) The Maternal and Child Health Service provides child-focused, family-centred practice to strengthen the capacity of families to make informed decisions about the child’s development and the family’s health, safety and wellbeing.

Standard 3:

Partnerships and

collaboration

The Maternal and Child Health Service builds partnerships with families and communities and collaborates and integrates with other services and organisations.

(29)

2. Working with other services and organisations

a) The Maternal and Child Health Service facilitates linkages and referrals to relevant community and professional services in order to meet the identified needs of the child and family.

b) The Maternal and Child Health Service collaborates with relevant services to promote and support integrated service delivery when the child and family are accessing other services.*

3. Working with the community

The Maternal and Child Health Service works with its local community to strengthen community capacity.*

(30)

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

1. Working with the mother and family

a) The Maternal and Child Health Service provides child-focused, family-centred practice, working in partnership with the child and family.

• The Maternal and Child Health Service has policies and

procedures outlining the child-focused, family-centred approach to service delivery.

• Support and training for the maternal and child health workforce facilitates working in partnership with the child, mother and family, in a strength based approach.

• The child, mother and family are included in identifying the approach to service delivery for their child.

• policies and procedures • evidence of training for

maternal and child health workforce

• survey of families

b) The Maternal and Child Health Service provides child-focused, family-centred practice to strengthen the capacity of families to make decisions about the child’s development and the family’s health, safety and wellbeing.

• The maternal and child health workforce works with the mother and family to increase their confidence and capacity to make decisions about the child’s growth and development and the family’s health, safety and wellbeing.

• The maternal and child health workforce considers the capacity of families to make decisions about the child’s development and the family’s health, safety and wellbeing.

• 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.

• evidence of use of health promotion skills and review of change in behaviour

(31)

Criteria element

Performance criteria

Examples of evidence

2. Working with other services and organisations

a) The Maternal and Child Health Service facilitates linkages.

• The Maternal and Child Health Service identifies relevant community resources, activities and services in their local community, and information on these resources is available for mothers and families.

• The Maternal and Child Health Service identifies relevant professional resources and services for the child and family to support their health, safety and wellbeing.

• The Maternal and Child Health Service has documented policies and procedures for referral processes.

• Referrals include at a minimum:

– child’s name, date of birth and contact details – mother’s and other relevant family names, – reason for referral

– relevant health information

– any other information relevant for service delivery by the referred service be typed or written legibly on official paper. *

• community resources on noticeboards, local government or the governing authority website and other locations

• handouts, flyers in waiting area

• documentation availability of community resources for maternal and child health workforce

• range of referral to professional resources and services

• survey of services to whom Maternal and Child Health Service refers

(32)

Criteria element

Performance criteria

Examples of evidence

b) The Maternal and Child Health Service collaborates with relevant services to promote and support integrated service delivery when the child and family are accessing other services.*

• The Maternal and Child Health Service collaborates with early years services, health services and local organisations/ programs to provide integrated service delivery for the child and family.

• The Maternal and Child Health Service works in collaboration with other services to coordinate services for children with health and/or psycho-social vulnerabilities or risk factors. • The Maternal and Child Health Service uses a multidisciplinary

approach to support collaboration and service coordination. • The Maternal and Child Health Service acts as an advocate for

the child and family when collaborating and integrating with other services.

• Information about the Maternal and Child Health Service, including how to access the service, is provided to local community and professional services.

• The Maternal and Child Health Service is promoted by DEECD, Municipal Association of Victoria (MAV), the local government or the governing authority and other relevant bodies.

• Referrals from/to maternity services conform with the Continuity of Care Protocol.* 27, 28

• Maternal and Child Health Service information on DEECD website and local government or governing authority website • audit of referrals from

other services

3. Working with the community

The Maternal and Child Health Service works with its local community to strengthen community capacity.*

• The Maternal and Child Health Service strengthens community capacity through assisting the establishment of community programs specific to the health and wellbeing needs of the local community.

• The Maternal and Child Health Service strengthens community capacity and assists with the development of community networks through contributing to established community and volunteer programs.

• evidence of activities to strengthen community capacity

• establishment of liaison meetings and/or networks with community planning staff, and other relevant departments/groups

(33)

Rationale

A competent and professional maternal and child health workforce is essential for the optimal delivery of the Maternal and Child Health Service. In order to provide a safe and quality service, the maternal and child health workforce is required to be suitably qualified, with relevant knowledge and skills to undertake the position. New and existing members of the maternal and child health workforce

are supported to learn, develop and strengthen the skills, knowledge and understanding required to deliver the Maternal and Child Health Service.29 This process is supported by performance review, with the identification of training and professional development needs.

The Maternal and Child Health Service, through the local government or governing authority and DEECD, is supported by effective human resource management and planning. The local government or governing authority complements and supplements work undertaken by DEECD and other relevant authorities. This includes the identification of the current and future needs of the workforce and the Service, implementation of effective strategies to recruit and retain the workforce and an understanding of the capacity within and requirements of the Maternal and Child Health Service.30

Criteria for Standard 4

1. Workforce

2. Human resource management and planning

3. Performance development and continuing education 1. Workforce

a) The Maternal and Child Health Service employs a workforce qualified to meet the objectives of the Maternal and Child Health Service.

b) The maternal and child health nurses maintain the requirements of

Standard 4:

Competent and

professional

workforce

The Maternal and Child Health Service is delivered by a competent and professional workforce.

(34)

2. Human resource management planning

a) Human resource management supports the 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 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.

(35)

Standard 4 – The Maternal and Child Health Service is delivered by a competent and professional workforce

Criteria element

Performance criteria

Examples of evidence

1. Workforce

a) The Maternal and Child Health Service employs a workforce qualified to meet the objectives of the Maternal and Child Health Service.

• The Maternal and Child Health Service employs nurses who are registered with the Nurses Board of Victoria as Registered Nurses Division 1, registered midwives holding an accredited post-graduate qualification in maternal and child health nursing.

• Where a workforce (support workforce) is employed to support and complement the skills of maternal and child health nurses, they are suitably qualified and experienced to meet the objectives of the Service.* The support workforce may include: – administration workers

– family support workers – Aboriginal Health workers

– cultural workers appropriate to local community (see Standard 1 Criterion 3)

– mental health workers – psychologists

– drug and alcohol workers

– other workers or health professionals as required. • The support workforce have relevant qualifications and or

experience to work in the Maternal and Child Health Service and, where relevant, have professional registration and maintain the requirements of professional registration.

• evidence of current registration

• evidence of qualifications • position descriptions with

selection criteria and key performance indicators for nursing and non-nursing positions

(36)

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 practise within the requirements of their registration, including within the following codes, standards and guidelines:

– National competency standards for registered nurses 31 – National competency standards for midwives 32 – Scope of nursing and midwifery practice 33 – Code of ethics for nurses in Australia 34 – Code of ethics for midwives in Australia 35

– Code of professional conduct for nurses in Australia 36 – Code of professional conduct for midwives in Australia 37 – Delegation and supervision for registered nurses 38 – Guidelines for continuing professional development 39 – Professional boundaries 40

– any guidelines, codes or other relevant documents that may be updated or implemented as a result of national registration relating to registered nurses and/or midwives.

• evidence of maintenance of registration, including professional development activities

• policies and procedures • evidence of facilitation

of professional

development, mentoring, support, clinical

supervision, peer support and feedback

• health record audit

c) The maternal and child health workforce has knowledge of, and complies with, their legislative requirements.

• The maternal and child health workforce meets the legislative requirements of the following Acts and Regulations:

– Children, Youth and Families Act 200516 – Child Wellbeing and Safety Act 200541 – Health Records Act 200142

– Family Violence Protection Act 200843_.

• The maternal and child health workforce is trained in their requirements under the:

– Children, Youth and Families Act 2005

– Child Wellbeing and Safety Act 2005

– Health Records Act 2001

– Family Violence Protection Act 2008.

• record of training undertaken

• record of mandatory education provided • policies and procedures

(37)

Criteria element

Performance criteria

Examples of evidence

d) The maternal and child health workforce has knowledge of, and complies with, these Standards and the Maternal and Child Health Program Resource Guide.

• maternal and child health workforce is aware of, and complies with, these Standards.

• The maternal and child health workforce is aware of, and has the skills and knowledge to comply with, the Maternal and Child Health Program Resource Guide.7

• evidence of compliance with standards

• evidence of training in revised Key Ages and Stages framework • evidence of compliance

with the Maternal and Child Health Program Resource Guide

(38)

Criteria element

Performance criteria

Examples of evidence

2. Human resource management and planning

a) Human resource management supports the delivery of the Maternal and Child Health Service.

• The Maternal and Child Health Service, through the local government or governing authority, has documented human resource management policies and procedures.

• The human resource management policies and procedures includes, as a minimum, information on:

– recruitment, selection and appointment processes – working hours/days

– pay and performance – leave and illness

– induction, training and education

– workplace relations, including grievance processes – performance development

– dress code

– management of students, including work experience of university and other students.

• The Service has policies and procedures for relievers within the Service.

• The maternal and child health workforce is aware of, and has access to, the Maternal and Child Health Service human resource management policies and procedures and the position description for their position.

• The human resource management policies and procedures are regularly updated, with input from the maternal and child health workforce.

• The Service has a confidential and secure personal file for each maternal and child health worker containing:

– position description – performance reviews

– performance development and professional education undertaken

– evidence of qualifications and registration

– other requirements of employment (for example, police check, driver’s licence and evidence of registration with the Nurses Board of Victoria).

• policies and procedures • staff survey

• review of staff turnover • exit interviews

• local government or governing authority strategic plan • evidence of

Maternal and Child Health Service. Program Standards

www.education.vic.gov.au/

ecsmanagement/mch/policy/default.htm

Maternal and Child

Health Service

Maternal and Child Health Service

Program Standards

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Contents

1.1 Maternal and Child Health Service:

Vision, mission, goals and principles

1.1.1 Vision

1.1.2 Mission

1.1.3 Goals

1.1.4 Principles

1.2 Overview of Maternal and Child

Health Service

1.2.1 Universal Maternal and Child Health Service

1.2.2 Enhanced Maternal and Child Health Service

1.2.3 Maternal and Child Health Line

2.1 An evidence-based framework

2.2 Structure of the Program Standards

Standard Three

Standard Four

Standard One

Standard Five

Standard Two

2.3 Purpose and use of the Program

Standards

2.4 Assessment against the Program

Standards

Rationale

3 The Maternal and Child Health

Service Program Standards

Standard 1:

Universal access

Criteria for Standard 1

Criteria element

Performance criteria

Examples of evidence

Criteria element

Performance criteria

Examples of evidence

Criteria element

Performance criteria

Examples of evidence

Criteria element

Performance criteria

Examples of evidence

Criteria element

Performance criteria

Examples of evidence

Rationale

Criteria for Standard 2

Standard 2:

Optimal health and

development

Criteria element

Performance criteria

Examples of evidence