Maternal and Child Health Service. Program Standards

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1 Maternal and Child Health Service Maternal and Child Health Service Program Standards

2 Contents Terms and definitions 3 1 Introduction Maternal and Child Health Service: Vision, mission, goals and principles 1.2 Overview of Maternal and Child Health Service 8 2 Background An evidence-based framework 2.2 Structure of the Program Standards Purpose and use of the Program Standards 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 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 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 Also published on 2 Victorian Maternal and Child Health Service

3 Terms and definitions 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 Victorian Maternal and Child Health Service 3

4 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. 4 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 Service 5

6 1 Introduction 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 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 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 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. 6 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 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 Service 7

8 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 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 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. 8 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 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 Service 9

10 2 Background 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 Victorian Maternal and Child Health Service

11 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 One Standard Two Standard Three Standard Four Standard Five Standard Six Figure 1: Relationship between the Maternal and Child Health Program Standards. Victorian Maternal and Child Health Service 11

12 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. 12 Victorian Maternal and Child Health Service

13 3 The Maternal and Child Health Service Program Standards 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. 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. 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, the Service must provide a flexible service that responds to the needs of all young children and their families. In addition to providing a universal service, the Service focuses on approaches to include families not engaged by the Service and those with the greatest burden of morbidity and risk. The Service actively seeks to identify and respond to children at risk of poor outcomes, and engage all families regardless of their cultural and linguistic background. 15 Victorian Maternal and Child Health Service 13

14 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. 14 Victorian Maternal and Child Health Service

15 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 eighteen months two years three-and-a-half years. The Maternal and Child Health Service acknowledges the right of the family to choose not to access the Service. Maternal and Child Health Service participation rates survey of families attending processes for contacting families who do not engage with the Service Victorian Maternal and Child Health Service 15

16 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 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 16 Victorian Maternal and Child Health Service

17 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 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 and in the Program Resource Guide. vic.gov.au/edulibrary/public/earlychildhood/mch/ guideproviderresource.pdf 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 Victorian Maternal and Child Health Service 17

18 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 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 and abuse. 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. 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 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 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 number of notifications made to Child Protection evidence of knowledge of staff evidence of training 18 Victorian Maternal and Child Health Service

19 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 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 languages and for mothers and families who have low literacy in English and languages other than English. 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 Victorian Maternal and Child Health Service 19

20 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. 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 evidencebased 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 14, 17, 19 and safety of the child. 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 child 21, 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 health 4, 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. 20 Victorian Maternal and Child Health Service

21 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. 4. Role of the family 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 through the participation in and support of research. Victorian Maternal and Child Health Service 21

22 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, socialemotional, 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 indicators 23, 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 22 Victorian Maternal and Child Health Service

23 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 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. 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 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). 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 count of reasons for counselling 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 Victorian Maternal and Child Health Service 23

24 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 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 24 Victorian Maternal and Child Health Service

25 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 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 Victorian Maternal and Child Health Service 25

26 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 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 4. Role of the family 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 26 Victorian Maternal and Child Health Service

27 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 5. Service delivery based on evidence a) The Maternal and Child Health Service delivers evidencebased 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 evidencebased 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 Victorian Maternal and Child Health Service 27

28 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. 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 17, 26 for the vulnerable child. 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. 28 Victorian Maternal and Child Health Service

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