Rural Obstetrics and Maternity Sustainability Program

The Rural Obstetrics and Maternity (ROAM) Sustainability Program focuses on the facilitation of locally driven, interprofessional, and team-based initiatives and networks aimed at addressing stability and sustainability in rural maternity care across British Columbia (BC). Many of these communities remain at risk of obstetric service reductions or closures. With funding available for 32 rural 1A and 1B communities that have planned maternity services, ROAM aims to increase 

the confidence, competence, and resiliency of all members of the interdisciplinary maternity care team, foster “community-determined safe birth environments” based on holistic risk assessment, cultivate shared responsibility and accountability across networks, and support the delivery of person and family-centred care closer to home.   

Our Achievements

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Expanded ROAM funding utilization, participation and activities in rural communities

Despite ongoing pandemic-related challenges and stressors experienced in rural communities and by rural maternity care providers through 2021–22, ROAM continued to grow. The ROAM team helped 31 rural communities utilize their funding and participate in ROAM-enabled activities this year. Building on the previous year, maternity teams in four communities were onboarded into ROAM, four teams submitted new plans and began local implementation and, in 23 communities, interprofessional teams continued or expanded their ROAM-supported activities through the fiscal year.  

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Hosted four province-wide networking events

The ROAM team hosted four province-wide virtual ROAM Networking events in the second half of 202122. Network events focused on enhancing team-based care, innovative coaching opportunities, and exploring the Maternity Tracker tool. December’s Holiday Social was attended by over 25 participants from more than a dozen rural communities. These successful networking events will continue through 202122. 

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Seamlessly transferred Maternity and Babies Advice Line to Real-Time Virtual Support

In the spring of 2021, the province’s Maternity and Babies Advice Line (MaBAL) moved from under the umbrella of ROAM to take up permanent residence with the provincial suite of Real-Time Virtual Support services, supported by the Rural Coordination Centre of BC. MaBAL is a 24/7/365 just-in-time, peer-to-peer virtual support service utilized by rural providers across the province. In addition to this, the MaBAL team of rural physicians and midwives is building capacity for hosting scheduled virtual coaching sessions with rural maternity teams and drop-in sessions for rural nurses.  

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Streamlined operations for communities participating in ROAM and the Rural Surgical Obstetrical Network

Throughout the year, ROAM also continued working closely with the Rural Surgical and Obstetrical Network to create integration between the two programs amongst the communities that are participating in both programs. To maximize flexibility for local teams, the ROAM funding pots previously allocated separately for the local team and network initiatives and coaching were combined. This community-responsive change enabled teams to draw from the combined funding to better address locally identified needs and priorities.  

Making a Difference

The success of the ROAM continues to grow year over year with new communities signing on—and more funding being used by communities to stabilize and sustain maternity care.  

“Commonly, ROAM teams are using available funding to come together and discuss local services, recruitment, retention, and referral patterns, and to review local standards, guidelines, and cases,” explains Lee Yeates, a registered midwife who co-leads ROAM with Dr. Sara Sandwith. “They’re also using it to develop and implement team learning sessions, to participate in clinical coaching and learning that increases confidence and builds capacity, and to work together on various local priority projects.”  

Through ROAM’s ongoing evaluation, maternity team members report positive local impacts, including stronger relationships among team members and between disciplines, streamlined processes and protocols locally and with referral sites, increased linkages with other health and social service providers, and successful implementation of new initiatives to improve patient care and the patient experience.  

“The ROAM activities were so impactful for our community,” said members of one ROAM team. “Without the support of ROAM, the maternity team wouldn’t have been able to flourish as a team. The weekly meetings and case reviews were so important—and additionally important during Covid.”   

“We’ll continue supporting rural maternity teams through one-to-one strategic planning, collaborative development, and coaching facilitation meetings with communities, in addition to continuing to host regular networking events,” says Lee. “And our second-year evaluation and community case studies will also be completed and used to inform our work with provincial partners to elevate rural maternity and the needs of rural maternity care providers and patients across the policy and planning landscape.”   

In addition to this, the ROAM team will continue mapping provider and patient maternity care referral networks and corridors of care throughout the province.

Team Members

Lee Yeates, RM
Lee Yeates, RM

Co-Lead, Rural Obstetrics and Maternity Sustainability Program (ROAM-SP)

Dr. Sara Sandwith
Dr. Sara Sandwith
Andrea McKenzie, RN
Andrea McKenzie, RN
Dr. Heather Gottlieb
Dr. Heather Gottlieb
Kim Williams

Kim Williams

Networks Director

Adrienne Peltonen

Adrienne Peltonen

Project Manager

Samantha Wood

Samantha Wood

Former Program Assistant