Quality of Care Evaluation Form

Quality of Care Evaluation Form

Please take some time to provide us with your evaluation of the Midwifery care that you received during your recent pregnancy, birth, and postpartum period. You do not need to identify yourself unless you would prefer to do so. Your comments will be reviewed by Thames Valley Midwives and can help us improve the quality of care we provide to our clients.

The questions in this section cover your Midwifery care from pregnancy, through labour and birth and after your baby’s birth until six weeks postpartum. Please check one answer for each question.

Please answer the questions if you had any involvement with a doctor in your care. If you did not have any doctor involvement, you can move on to section D.

Office Administration

  • Section A
  • Section B
  • Section C
  • Section D

Rate the following aspects of your prenatal, labour and birth, and postpartum care. Check one rating choice for each sub-category:

Your age

Was this your first birth?

Was this your first birth with a midwife?

Prenatal Care:

1. Number of prenatal visits

2. Length of my prenatal visits

3. Scheduling of my prenatal visits

4. Usefulness of information provided to me for making decisions

5. How easy it was to reach my Midwife or Midwives

6. My confidence in the Midwives’ skills and abilities

7. How comfortable I felt asking questions

Labour and Birth Care:

1. How easy it was to reach my Midwife or Midwives during labour

2. My confidence in the Midwives’ skills and abilities

3. Usefulness of information provided to me for making decisions

Postpartum Care:

1. Number of my postpartum visits

2. Length of my postpartum visits

3. Scheduling of my postpartum visits

4. How easy it was to reach my Midwife or Midwives

5. Usefulness of information about caring for myself

6. Usefulness of information about caring for my baby

7. My comfort calling my Midwife or Midwives with questions or problems

8. My confidence in the Midwives’ skills and abilities

CONTINUITY OF CARE: Midwives must ensure that clients have no more than four Midwives involved in their care and that there is 24 hour on-call access through pregnancy, labour, and postpartum.

1. Did you know which Midwife or Midwives were primarily responsible for your care?

2. Were there adequate opportunities for you to meet the Midwives involved in your care?

3. Did you understand how to reach a Midwife 24 hours a day?

INFORMED CHOICE: Midwives must provide clients with information about their education and experience, how Midwives practice in Ontario and what standards and protocols they must follow. Throughout care, Midwives must provide clients with enough information to make informed decisions regarding their care.

1. In general, were your choices and decisions respected by your Midwife or Midwives?

2. Did you receive enough information to make informed decisions about your care?

3. Were you given enough information to decide choice of birth place?

CONSULTATION AND TRANSFER OF CARE: Midwives are required to consult with physicians for certain conditions that may arise during pregnancy, labour, and postpartum. Some conditions require that a physician take over care.

1. Did you understand the reasons why a doctor might become involved in your care?

2. Did your Midwife need to consult with a doctor during your care?

3. If you answered “yes” to the above, did you understand why and what would happen?

4. Was your care transferred to a doctor?

5. If you answered “yes” to the above, did you understand why and what would happen?

OFFICE SERVICE: If you had contact with staff in our London office, please answer the following questions.

1. Accessibility of staff

2. Information provided by staff on first contact

3. Reception when arriving for appointments

4. Physical surroundings of clinic space

5. Waiting time for appointments

EDUCATIONAL MATERIALS

1. Did you borrow any resources from our lending library?

2. Did you find the information useful?

3. Did you find the information on our webpage client area useful?