1. Mums and Bubs team engaging our mob at Danila Dilba Theresa Kassman Support Worker Elle Crighton Midwife/Nurse

2. Mums and Bubs team Support worker 2 Midwives 1 Indigenous Student Midwife (grow our own) Antenatal Doctor Sujatha Thomas monthly visiting obstetric consultant

3. High Risk consultant clinic at DDHS
One consultant whom attends DDHS monthly reviewing high risk clients. Dr Sujatha Thomas works closely with our Mums and Bubs team.
I drop off letters to each client late in the week prior to clinic, I follow up with text reminder of appointment and re organise appointment times if there is any clashes and help with transport to help facilitate clients attend antenatal high risk DDHS.

4. Danila Dilba confirm pregnancy
Confirm pregnancy on communicare
This clients name is generated on antenatal pregnancy list.
Once a pregnancy is confirmed on communicare it notifies the Mum and Bub team of pregnancy. Team do not need to go looking for client or other health practitioners don't need to communicate with team it is automatic. Pregnancy list printed off weekly. The pregnancy list now has future appointment so I can see at a glance who does not have a future appointment and shows who she needs to engage with. Challenges experienced in past support work needed to open every client file every week to see if they had a future appointment large drain on resources & time intensive. Also in the past if a client was from out of area having one of visit clinicians do not generate pregnancy. Events occur, car issues, family issues and client did not return to community often missing weeks of antenatal care. We now generate pregnancy and follow up with the community to ensure they are engaged with them or follow them up in town. The team check client phone number and address at each contact to ensure we can find the client Historically if client lived at community they had that as their address. We try and find a address they are staying at whilst in town to help with follow up and current phone number. We reviewed statistics and found some client were engaging early but their were system errors with using antenatal template. Educate new staff and ongoing organisation education to ensure data is accurately reflective

5. How do we engage our clients?
Full time support worker. Engages and works with client with complex needs.
Increased Midwife present, clinics close to where clients live
Palmerston, Malak and Knuckey.
Flexible structure, walk in appointments; now after hours clinics. Pregnant client are a priority and always seen.
Mobile caravan clinic engages women early in pregnancy journey.
Home Visits to engage clients, home visit antenatal care an option.
All antenatal care at Danila Dilba including Consultant clinic and GTT clinic.
New after hours clinic to engage younger population
Found clients were not keen to attend RDH review consultant DDHS is well attended.
GTT client not keen to wait around the local pathology service we have 2 monthly GTT clinic with a big mob of food after clinic. Screening attend as pre Carp guideline early GTT and 28 weeks

7. Broad scope of practice
Support worker/midwife sort the flat get out
No stopping them engaging Danila Dilba clients

8. Right spirit for the job
Support worker/midwife sort the flat get out their to out clients! Winner
Theresa having a yarn whilst transporting the client hears their story really knows the clients well.
In the car in confined space client open up and tell their story!

9. Barriers to service Rapport Communication Transport Flexibility
Waiting Times
Rapport the client come to DD as they have a connection with us & we have holistic approach for the client and their family. Friendly staff. GP Dr Fon has been at Danila Dilba since Communication talk to client often reminding them of appointment. Communicare now has text message service for all DD appointment all other appointment u/sound sent text message and Theresa also follows up. Challenges for our clients transport- catching bus on busy road waiting in rain etc. All client have transport to all appointments cardiologist, u/sound. I can pick up client and walk them to RDH to help client negotiate these services. Flexibility building relationship know the family issue with family adapt care to meet their need home visit or very quick clinic consult if client needs to go. Lack of communication when attending high risk clinics outside DD. Our system tracks waiting time all clinicians mindful of time management and minimize clients wait times. Evidence shows this is the biggest complaint with all pregnancy care throughout Australia client have busy lives and do not like to wait. Historically long wait times at antenatal clinic at the local hospital clients vote with their feet and leave.

10. Engaging the family
I meet clients at their home and walk the antenatal journey with the client

11. Engagement with appointments
I walk the client to RDH to show them where to go what to do and next I love it next visit the client has more confidence to engage with the outside health service

12. Rapport
This show the rapport this is Grandmother attending for Boostrix prior to birth of baby. After hours clinic

13. Della Mayo
Then new born baby and home visit with DDHS team.

14. Home visit
All the family have a connect with DDHS

15. Holistic Approach Whole family approach

16. Family share the journey
Making visits fun for the whole family

17. Building Rapport
Sometimes the first antenatal encounter is not a positive story
A plan is made so the next pregnancy can hopefully have a better outcome

18. Statistic of first antenatal review
Daneille Green can speak to this slide. Our thought our clients where presenting early. When we reviewed the data we found the most late presentations where clients out of the area whom had engaged with antenatal care earlier. Some systematic errors have been identified and addressed include the antenatal check template is used at first presentation other wise communicare will not recognize the visit as first antenatal visit. The client could have numerous visits when were free texted in communicare not using correct template and altering stats

19. We love seeing our beloved staff engaging our service