Bridging Between Professionals in Perinatal Care: Towards Shared Care in The Netherlands

Abstract

Relatively high perinatal mortality rates in the Netherlands have required a critical assessment of the national obstetric system. Policy evaluations emphasized the need for organizational improvement, in particular closer collaboration between community midwives and obstetric caregivers in hospitals. The leveled care system that is currently in place, in which professionals in midwifery and obstetrics work autonomously, does not fully meet the needs of pregnant women, especially women with an accumulation of non-medical risk factors. This article provides an overview of the advantages of greater interdisciplinary collaboration and the current policy developments in obstetric care in the Netherlands. In line with these developments we present a model for shared care embedded in local 'obstetric collaborations'. These collaborations are formed by obstetric caregivers of a single hospital and all surrounding community midwives. Through a broad literature search, practical elements from shared care approaches in other fields of medicine that would suit the Dutch obstetric system were selected. These elements, focusing on continuity of care, patient centeredness and interprofessional teamwork form a comprehensive model for a shared care approach. By means of this overview paper and the presented model, we add direction to the current policy debate on the development of obstetrics in the Netherlands. This model will be used as a starting point for the pilot-implementation of a shared care approach in the 'obstetric collaborations', using feedback from the field to further improve it.

Improving interprofessional coordination in Dutch midwifery and obstetrics: a qualitative study

“…the involvement of more than one level of care [23]. Such meetings are already in place in some areas and could increase interprofessional communication, such as mutual trust and shared knowledge [18].…”

An examination of the historical context of interprofessional collaboration in Dutch obstetrical care

“…Also, over the last two decades, so called ''Verloskundig Samenwerkingsverbanden'' (local obstetrical partnerships) have been founded. These partnerships are usually formed by obstetricians of a single hospital and all midwifery practices surrounding it and aimed at developing and optimizing shared care (Posthumus et al, 2013).…”

“…For example, they jointly design care protocols and monitor quality of care, midwives consult obstetricians about patients and they collaborate on the labor ward if a patient's care during labor is transferred from the midwife at home to the obstetrician in the hospital (Posthumus et al, 2013). Both the obstetricians and midwives have separate professional societies, the Dutch Gynecological Society (NVOG) which was founded in 1887 (NVOG, 2013) and the Dutch Organization of Midwives (KNOV) founded in 1898 (KNOV, 2009).…”

The Dutch national summit on preconception care: a summary of definitions, evidence and recommendations

“…Care pathways are a means of achieving multidisciplinary agreements on organization and efficient shared care. They should be evidence based and in line with local guidelines and available care facilities (Posthumus et al 2012). organizations should have a leading role in the development in care pathways, specifically to achieve multidisciplinary agreements.…”