Lessons learned from the implementation of Canada's first alongside midwifery unit: A qualitative explanatory study

Area of Science:

• Healthcare innovation and implementation science.
• Midwifery models of care.
• Health services research.

Background:

• Canada's first midwife-led Alongside Midwifery Unit (AMU) opened in July 2018 at Markham Stouffville Hospital (MSH).
• This study examines the conditions enabling the AMU's creation and identifies lessons for wider adoption.

Purpose of the Study:

• To analyze the factors influencing the implementation of Canada's first Alongside Midwifery Unit (AMU) at Markham Stouffville Hospital.
• To identify transferable lessons for the successful spread of AMUs.

Main Methods:

• Key informant interviews and document analysis were conducted.
• The Consolidated Framework for Implementation Research guided study conceptualization and interview development.
• Data analysis employed a coding framework based on diffusion of innovations theory.

Main Results:

• Implementation was influenced by innovation characteristics, outer and inner settings, communication, linkage, and processes.
• Key success factors included organizational investment in midwifery leadership, change management theory, stakeholder involvement, and open communication.

Conclusions:

• The MSH-AMU demonstrates the value of change management and implementation theory for successful service model transformation.
• Lessons learned can guide the successful spread of this innovative midwifery care model.