Overview

BCCNM’s Quality Assurance Program (QAP) is designed to assure and improve the quality of clinical and professional midwifery practice. Its underpinning philosophy is that midwives are ultimately accountable and responsible for sustaining and enhancing their own knowledge, skills, judgement and competencies over a lifetime of practice. BCCNM supports midwives in achieving this through the following QAP requirements:

Clinical Experience

Hands-on, clinical experience is integral to a midwife’s knowledge, skills and ability to continue to provide ongoing safe clinical care. Midwives are required to stay clinically active in the provision of prenatal, intrapartum and postpartum care over a rolling period of three years in order to maintain status as practising registrants. At the time of annual renewal, midwives are required to report on clinical activities over the preceding three year period. Please note that midwives in their first two years of practice have additional active practice requirements.

Policy on Active Practice Requirements (PDF)

Continuing Professional Development (CPD)

As per the Policy on Continuing Competencies (PDF), midwives are required to recertify in mandatory CPD for continuing competency in the following:

Neonatal Resuscitation (NRP)
Cardiopulmonary Resuscitation (CPR)
Fetal Health Surveillance (FHS)
Emergency Skills (ES)

Midwives are also required to engage in 45 credits of additional self-directed, accredited CPD activities on a three-year cycle as specified in the Policy on Continuing Professional Development (PDF).

Continuing Professional Development Scoring Framework

Practising Registrants are required to complete a minimum of forty five (45) continuing professional development (CPD) credits per 36-month (three year) cycle. BCCNM endorses the College of Family Physicians of Canada’s accreditation system and accepts Mainpro+ credits on par. This framework is designed to assist registrants in assigning BCCNM CPD credits to a variety non- Mainpro+ accredited CPD activities.

BCCNM CPD credit assignment for non- Mainpro+ accredited activities¹

Hourly

One credit per hour (0.25 credits per 15-minute increment)	Two credits per hour (0.50 credits per 15-minute increment)	Three credits per hour (0.75 credits per 15-minute increment)
Non- accredited seminar or conference attendance Hospital rounds attendance Local, midwifery-related volunteer work	Journal club attendance Presenting at a conference Non- accredited online module or course Course instruction (midwifery-related) Midwifery curriculum review	Interprofessional, interactive workshops and/or simulation events (maximum nine credits per event) Interactive chart audit process (maximum nine credits per event)

¹ This list is not exhaustive. Contact BCCNM to discuss credit assignment for CPD activities not listed.

Activity based

Type of activity	Credit assignment
Reviewing print-based or flat media (i.e. journal articles,webinars, online rounds, podcasts) and completing BCCNM reflective exercise	1 credit per activity completed
Preceptoring midwifery, nursing or medical students/residents	3 credits per completed term
Mentoring new registrants	1 credit per month
Serving on a panel, committee or Board of a related professional or regulatory organization (i.e., BCCNM, MABC, SOGC, PSBC, CAM, etc.)	20 credits per article published

References

Austin Z, Gregory P. Professional Quality Assurance and Competency Assessment: A Scoping Review (Version 1). Unpublished paper. 2015; August 31; 1-72.

Latka, P. Continuing Professional Development Scoping Review and recommendations. Unpublished paper. 2017.

Meuser J, Hill L, Outschoorn A. Learning to Change: Coming Updates to the CFPC Mainpro Program. Canadian Family Physician. 2013; 59 (September); 913-914.

College of Family Physicians of Canada. Mainpro+ Quality Criteria Scoring Framework. Canadian Family Physician. 2016; 1-7.

Comfort, R. Environmental Scan of QA Programs. Unpublished paper. 2017.

Comfort, R. Currency and Competency: Jurisdictional Review. Unpublished paper. 2017.

Self-assessment

Midwives are required to participate in ongoing self assessment in order to promote reflective practice and accountability in maintenance and enhancement of knowledge, skills, and ability.

New for 2022

Beginning in 2022, midwives registered with BCCNM will complete an annual self-assessment questionnaire (PDF) as part of registration renewal. The questionnaire is based on the Standards of Practice and Code of Ethics and is an opportunity for midwives to complete a thorough assessment of their practice.

Questions? Email qualitymidwives@bccnm.ca

Provision of Clinical Information

This component of the QAP allows the BCCNM Quality Assurance (QA) Committee to request specific, de-identified information relating to the care given by midwives to clients, to assess for themes in practice or prescribing patterns. For an example of how this component of the QAP can be used, the QA Committee required midwives to seek peer review and maintain a log on their first three inpatient orders and first three outpatient prescriptions when midwives were first given the authority to prescribe controlled substances as per the Standards for Prescribing, Ordering and Administering Controlled Substances (PDF).

Peer Case Review

Midwives are required to participate in a minimum of four peer case reviews per registration year. Peer case review consists of a review of clinical care and is intended to be educational, confidential and conducted in a supportive, non‑punitive environment. At least two midwives and two midwifery practices must be present at each peer case review, which must include the following:

A presentation of a case history to date including available information on medical, family, obstetrical and psychosocial history, family circumstance, relevant lab work, test results, ultrasound findings, and significant developments when applicable over the course of pregnancy, labour, birth and postpartum period.
An explanation of how the case was managed by one of the midwives participating in the review, including consultations and/or transfer of care to other health care providers.
A discussion of the application of BCCNM regulations, standards, clinical practice guidelines and policies to the case.
Client feedback on care provided if available.
Observations and feedback by peer case review participants.
An explanation of changes made or recommendations for potential changes in practice if applicable.

Evaluation of Midwifery Care

BCCNM is in process of developing an integrated, validated multisource feedback tool that integrates client feedback with self-assessment and peer feedback. Until the tool is ready for deployment, midwives are required to distribute a copy of the Client Evaluation of Midwifery Care (PDF) form to each client, within six months of that client being discharged from care, and request that the client complete and return the evaluation to the midwife’s practice. The evaluation form shall not identify the client. Midwives review these evaluations at regular intervals throughout the year and keep a record of any action taken in response to client evaluations. Completed evaluation forms and the record of action taken in response to the client evaluations are kept by midwives for six years from the date the evaluation form is returned in case of audit by BCCNM.