Exploring midwifery engagement and collaboration within integrative care models in Ontario, Canada
Bibliographic record
Abstract
Problem Statement: Since 2019, Ontario Health Teams (OHTs) have been forming to coordinate and streamline care across health sectors within the province of Ontario, Canada, but little is known about how midwives and their practice groups are engaging and collaborating within this model of care delivery. Background: In Ontario, midwives provide primary care for pregnancy, birth and postpartum, and are most commonly organized in midwifery practice groups as autonomous providers. From the literature we understand that factors such as funding, care model, and philosophical differences may pose challenges for midwifery integration and collaboration between health professions, and within team-based care models. The aim of this inquiry is to identify what is known about the engagement of midwives and their practice groups within OHTs. Additionally, by highlighting potential facilitators and challenges for midwifery collaboration within integrative care models, this study further aims to develop recommendations to improve engagement and inform future research directions. Who is it for? Findings from this inquiry describe facilitators and challenges for midwifery engagement within integrative care models, as well as recommendations, that are relevant for policy makers, healthcare organizations and primary care providers. These findings will also provide a foundation for future research and engagement with midwives, their organizations, collaborators and leaders within OHTs. What did you do? A rapid review of the literature and environmental scan related to midwifery partnering and collaborating within cross-sectoral integrative partnerships was undertaken. More specifically, we reviewed the literature to identify where and how midwives are engaging and collaborating within integrative care models, and identify facilitators and challenges to this collaboration. A review of OHT websites and public-facing documents was additionally undertaken to describe to what extent, and in what capacity, midwives and practice groups are engaging within OHTs. What results did you get? What impact did you have? Results from this preliminary inquiry provide context and a foundation for how midwifery professionals are engaged within integrative care models as collaborators within OHTs provincially. Findings from the literature identify facilitators and challenges to the collaboration by this professional group. In addition, results inform research questions and focus an approach for further exploration of the current state of midwifery engagement and collaboration within healthcare coordination at the OHT level. What is the learning for the international audience? While Ontario is working toward building integrative care models that include primary care providers, we anticipate that engagement and collaboration of midwifery practices and professionals within OHTs will vary across the province. Findings from this study may also offer insights regarding the engagement of other specialized services within OHTs. What are the next steps? The overall aim of this study is to develop recommendations to support the engagement and collaboration of midwifery professionals within integrative models, such as OHTs, and to identify areas for further inquiry.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.029 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.010 |
| Science and technology studies | 0.020 | 0.007 |
| Scholarly communication | 0.007 | 0.004 |
| Open science | 0.003 | 0.010 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".