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Centralisation of acute obstetric care in the Netherlands: a qualitative study to explore the experiences of stakeholders with adaptations in organisation of care.
van den Berg, Lauri M M; Gordon, Bernardus Benjamin Maria; Kleefstra, Sophia M; Martijn, Lucie; van Dillen, Jeroen; Verhoeven, Corine J; de Jonge, Ank.
  • van den Berg LMM; Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands. l.m.m.vandenberg@amsterdamumc.nl.
  • Gordon BBM; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6523 GA, Nijmegen, the Netherlands.
  • Kleefstra SM; Dutch Health and Youth Care Inspectorate, Stadsplateau 1, 3521 AZ, Utrecht, the Netherlands.
  • Martijn L; Dutch Health and Youth Care Inspectorate, Stadsplateau 1, 3521 AZ, Utrecht, the Netherlands.
  • van Dillen J; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6523 GA, Nijmegen, the Netherlands.
  • Verhoeven CJ; Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
  • de Jonge A; Maxima Medical Centre, Department of Obstetrics and Gynecology, De Run 4600, Veldhoven, Netherlands.
BMC Health Serv Res ; 21(1): 1233, 2021 Nov 13.
Article in English | MEDLINE | ID: covidwho-1526634
ABSTRACT

BACKGROUND:

In the past decade, acute obstetric care (AOC) has become centralised in many high-income countries. In this qualitative study, we explored how stakeholders in maternity care perceived and experienced adaptations in the organisation of maternity care in areas in the Netherlands where AOC was centralised.

METHODS:

A heterogenic group of fifteen maternity care stakeholders, including patients, were purposively selected for semi-structured interviews. An inductive thematic analysis was used.

RESULTS:

Three main themes were identified (1) lack of involvement. (2) the process of making adaptations in the organisation of maternity care. (3) maintaining quality of care. Stakeholders in this study were highly motivated to maintain a high quality of maternity care and therefore made adaptations at several organisational levels. However, they felt a lack of involvement during the planning of centralisation of AOC and highlighted the importance of a collaborative process when making adaptations after centralisation of AOC.

CONCLUSIONS:

Regions with AOC centralisation plans should invest time and money in change management, encourage early involvement of all maternity care stakeholders and acknowledge centralisation of AOC as a professional life event with associated emotions, including a feeling of unsafety.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Maternal Health Services / Midwifery / Obstetrics Type of study: Qualitative research Limits: Female / Humans / Pregnancy Country/Region as subject: Europa Language: English Journal: BMC Health Serv Res Journal subject: Health Services Research Year: 2021 Document Type: Article Affiliation country: S12913-021-07269-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Maternal Health Services / Midwifery / Obstetrics Type of study: Qualitative research Limits: Female / Humans / Pregnancy Country/Region as subject: Europa Language: English Journal: BMC Health Serv Res Journal subject: Health Services Research Year: 2021 Document Type: Article Affiliation country: S12913-021-07269-4