Developing obstetric care pathways:the birth of consensus

Professional cooperation with mother and child in the leading role is seen as an important factor in improving the quality of the Dutch obstetric care system. However, good cooperation is not self-evident. In order to promote cooperation between obstetricians, gynaecologists and maternity centres, integral care paths in which joint agreements have been made about care for mother and child have been worked on in Limburg over the past eight years. For this purpose, the ACCORD methodology has been developed, in which everyone is systematically consulted in advance, before the content of the care is prescribed. The ACCORD methodology can be used for any group of healthcare providers who want to reach a broad-based agreement. Additionally, the following has been investigated: 1) how well representation works if a group sends someone on its behalf to make decisions; is the group’s opinion well represented, 2) which factors, in addition to risk reduction, play a role in assessing risks and introducing interventions, and 3) which factors influence patient satisfaction related to obstetric care