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

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.

Citation

van den Berg, L. M., Gordon, B. B. M., Kleefstra, S. M., Martijn, L., van Dillen, J., Verhoeven, C. J., & de Jonge, A. (2021). Centralisation of acute obstetric care in the Netherlands: a qualitative study to explore the experiences of stakeholders with adaptations in organisation of care. BMC Health Services Research, 21, Article 1233. https://doi.org/10.1186/s12913-021-07269-4

• Journal Article Type: Article
• Acceptance Date: Oct 26, 2021
• Online Publication Date: Nov 13, 2021
• Publication Date: Nov 13, 2021
• Deposit Date: Jun 8, 2023
• Publicly Available Date: Jun 14, 2023
• Journal: BMC Health Services Research
• Electronic ISSN: 1472-6963
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Article Number: 1233
• DOI: https://doi.org/10.1186/s12913-021-07269-4
• Keywords: Health Policy
• Public URL: https://nottingham-repository.worktribe.com/output/21641020
• Publisher URL: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-07269-4
• Additional Information: Received: 2 August 2021; Accepted: 26 October 2021; First Online: 13 November 2021. The study was submitted to the Medical Ethics Review Committee of the VU University Medical Centre (reference number 2020.189). No ethical approval was needed, since the Medical Research Involving Human Subjects Act did not apply on this study, as there was no infringement of the physical and/or psychological integrity of the participants. All methods were carried out in accordance with relevant guidelines and regulations. Prior to the interview, informed consent was obtained from all subjects involved in the study. The authors declare that they have no competing interests.