When the Children’s Hospital of Saskatchewan (CHS) opens, the maternal floor will be the largest in the building. And it will operate much differently that it does now, using the concept of Family-Centred Maternal Care (FCMC) as its vision for care. Maternal care staff and physicians learned just what that means this week, when the guru of FCMC shared her knowledge with them as they prepare for moving into the new hospital in three years.

Dr. Celeste R. Phillips is an internationally recognized expert and leader in Family-Centred Maternal Care. She has spent the past four days with Saskatoon Health Region’s leaders, staff and physicians, training them all in this method, which is an evidence-based way of providing care to mothers and babies that is individualised and recognizes the importance of family support, participation and choice.

Dr. Celeste Phillips

After each of her seminars, Dr. Celeste Phillips answers questions from staff about how family-centred maternal care will work to make their new floor and its use of single room maternal care a model hospital for the country.

Dr. Phillips is a prolific speaker, author and consultant, having worked with over 700 hospitals in 50 U.S. states, Canada, Mexico, Europe and Asia. She has pioneered efforts to improve maternity care through family-centred practice for more than 40 years, and recently retired as president of Phillips+Fenwick, a women’s healthcare company.

As work began to prepare the operational plan for integrating the vision of Family-Centred Care into Maternal Services within Children’s Hospital of Saskatchewan, the CHS Maternal Services planning lead spent months of research on Single Room Maternity Care and FCMC. During this research, a common theme became apparent as almost all books and journal articles referencing these concepts were either written by or referenced Dr. Celeste Phillips.

Though Dr. Phillips had officially retired from consulting, when she received an email from the CHS Maternal Services planning lead asking for additional information, she was intrigued by the project. So intrigued, in fact, she offered to come out of retirement to help Maternal Services and learn more about the transformational change in maternal care being considered in Saskatchewan’s new provincial maternal and children’s hospital.

“We are very honoured Dr. Phillips decided to help us out,” Leanne Smith, Director of Maternal Services for Saskatoon Health Region, told staff at Monday’s training session of the conference, which was funded by a professional development grant.

Now 83, Phillips began her nursing career by training at Hollywood Presbyterian Hospital, before universities had nursing programs, and when mothers were put under anesthetic to give birth. She called it the “Wake me when it’s over” era when she spoke to staff. Now, we’re in the “I want it now” era, she said. But some things never change.

“There are some universal truths in our business. It’s not about you,” she said. “It’s about the patient. The patient comes first. Don’t forget that. You won’t be happy if it’s not about the patient. You’ll go home frustrated, upset that you’re not accomplishing what you want to do…. Family-Centred Maternal Care is all about the patient.”

The core values of FCMC are patient-first care, mutual respect and trust, informed choices, empowerment of patients, collaboration, flexibility, quality and individualized care.

In the current multi-transfer system at Royal University Hospital, women labour, deliver, recover and stay not only in different rooms, but in different units, transferring multiple times during their stay. Under the guiding principles of Family-Centred Maternal Care in the new maternal and children’s hospital, mothers will be in one room for labour, delivery, recovery and post-delivery care, with one set of caregivers. Babies will be in the room with their mothers, and the entire family is given support, encouragement and education by staff so everyone, from mom and dad to grandma, know what’s best for baby.

Staff sign posters.

Staff commit to living the vision for Family-Centred Maternal Care today and in the new maternal and children’s hospital.

“In Family-Centred Maternal Care, we try not to separate mothers and babies because we know they lock together,” Phillips told staff. “(Mothers) breastfeed best when not separated from baby.”

What’s also best for the patient, she continued, is a nurse who can take care of mother, baby and family together, not separately.

“What you’re going to do in Single Room Maternal Care is take care of the whole experience, from the time they enter the hospital to the time they leave…. This is the best way to provide care and research backs that up.”

It means that if there is a problem with a mom hours after she’s given birth, caregivers don’t have to call to another unit to find out what happened during the birth – they will already know.

“You’re not a part of her nurse, you’re her whole nurse,” Phillips said to staff. “You can take care of mothers and her family.”

Implementing this method of care will involve cross-training staff, some of whom may have been solely on one maternal care unit, such as Labour and Delivery, or Post-Partum for many years. It will be hard at first, Phillips promised them, but it will be worth it. Because this way of delivering care is better for the patient, it will be better for the caregivers.

After each seminar, staff spent time reflecting on what they already do today and what they else they can to do live family centred maternal care principles today.

After each seminar, staff spent time reflecting on what they already do today and what they else they can to do live family centred maternal care principles today.

Under the Family-Centred model, caregivers get to see the whole journey. They will get closure on each case. That’s why it gets the highest patient satisfaction scores, and in some hospitals, has earned 90 per cent employee satisfaction rates.

“Happy patients make happy nurses, which makes happy patients. It goes round and round,” Phillips said. “It’s holistic for staff. There’s closure. It’s what they hoped they would feel when they are at a birth…. Just a walking-on-air feeling.”

FCMC and SRMC rooms also mean improved productivity, Phillips said – nurses have more time with patients because they don’t spend so much time transferring them from unit to unit.

FCMC isn’t a wild and crazy idea, Phillips noted. Accreditation Canada has integrated patient- and family-centred care core concepts into the standards for all types of healthcare settings across Canada.

“We’re talking about mainstream,” she said.

Phillips’ visit to Saskatoon is not only meant to educate staff and engage physicians in FCMC, but also to develop a clear action plan for its implementation.