How good is collaboration between maternity service providers in the Netherlands?

Doug Cronie,1,2 Marlies Rijnders,3 Suze Jans,3,4 Corine J Verhoeven,5,6 Raymond de Vries7–9 1Department of Midwifery, OLVG (West) Hospital, Amsterdam, The Netherlands; 2Department of Midwifery Science, Faculty of Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands; 3Department of Child Health, TNO, Leiden, The Netherlands; 4Editorial Department, Dutch Journal for Midwives (KNOV), Utrecht, The Netherlands; 5Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands; 6Department of Obstetrics and Gynecology, Maxima Medical Centre, Veldhoven, The Netherlands; 7Faculty of Midwifery Education & Studies, Zuyd University, Maastricht, The Netherlands; 8CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands; 9Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, MI, USA Aims: To examine the experiences of inter-professional collaboration of maternity service providers in the Netherlands and to identify potential enhancing and inhibiting factors for inter-professional collaboration within maternity care in the Netherlands. Background: Good collaboration between health care professionals is a key element of safe, effective care, but creating a collaborative culture can be challenging. Good collaboration requires, among other things, negotiating different professional orientations and the organizational constraints of hierarchies and scheduling. Good collaboration is especially important in maternity care. In the Netherlands, suboptimal collaboration has been cited as a significant factor in maternal deaths and in adverse incidents occurring in hospitals during evenings, nights, and weekends. In spite of its importance for effective maternity care, little is known about the nature and quality of collaboration between maternity care professionals. In order to fill this gap, we examined the inter-professional collaboration within multi-disciplinary teams (MDTs) providing maternity services in the Netherlands. Methods: Online survey of MDTs (consisting of hospital and PCMs, doctors, and carers) involved in the provision of maternity services in the Netherlands. We used a validated measure of collaboration (the Leiden Quality of Work Questionnaire) to analyze the attitudes of those involved in the provision of maternity services about multi-disciplinary collaboration in their work. We used descriptive and inferential statistics to assess differences between the groups. Results: 40% of all respondents were not satisfied with collaboration within their MDT. Overall, mean collaboration scores (MCS) were low. We found significant differences in MCS between professional groups. Midwives – community and hospital based – were pessimistic about collaboration in future models of maternity care. Discussion: In the Netherlands, collaboration in maternity care is less than optimal. Poor collaboration is associated with negative consequences for patient safety and quality of care. Strategies to address suboptimal collaboration exist; however, no one-size-fits-all approach is identified in the literature. Conclusion: Suboptimal collaboration exists within the midwifery model of care in the Netherlands and the relationship between care providers is under pressure. This could affect patient safety and quality of care, according to the literature. Précis: This paper presents an in-depth examination of the nature of, and attitudes about, collaboration between members of the MDT involved in the provision of maternity services in the Netherlands. Keywords: interprofessional communication, communication, multi-disciplinary team, interprofessional teamwork, interprofessional collaboration survey, questionnaire hospital midwife, primary care midwife, midwifery, carer, doctor, nurse, maternity care assistant, integrated-car