No registrations found.
ID
Source
Brief title
Health condition
Perinatal morbidity and mortality / Perinatale morbiditeit en mortaliteit
Maternal morbidity and mortality / Maternale morbiditeit en mortaliteit
Deliveries (in particular those involving unplanned referral from primary to secondary- or tertiary care) / Bevallingen (betreffende een ongeplande overdracht van eerstelijns zorg naar tweede- of derdelijns zorg)
Sponsors and support
Intervention
Outcome measures
Primary outcome
Perinatal and maternal morbidity and mortality rates
Secondary outcome
- Participants' view of their learning experience and satisfaction with the intervention using an evaluation questionnaire
- Changes in attitudes, knowledge and skills of obstetrical professionals using the Safety Attitude Questionnaire for Teamwork and Safety Climate (SAQ) and Interprofessional Collaboration Measurement Scale (IPCMS)
- Changes in behaviour by monitoring telephone conversations to study communication during referrals and a vignettes study about decision making during labour
- Patient satisfaction after intrapartum referral
Background summary
The obstetrical care system in the Netherlands is performing suboptimal. Building on the same level of scientific knowledge, other Western-European countries have lower perinatal mortality rates. The objective of this research project is to improve perinatal outcomes by improving the quality of the referral process as well as the collaboration between professionals involved in the chain of obstetrical care. Moreover, a multidisciplinary team training aimed at the implementation of structured referral procedures will be developed and tested.
The research design is a longitudinal multicentre one, using continuous measurements of the primary outcomes and pre- and post-intervention measurements for other outcome measurements (see information above). The effects of the multidisciplinary team training will impact the organisation of obstetrical care at different levels. Therefore, Kirkpatrick's framework was adopted to measure outcomes at the level of the participants in the intervention, changes in attitudes, knowledge, and skills, changes in behaviour, and changes in patient outcomes and organisational practice. The start of the study is January 2013, the first multidisciplinary team training sessions for LOCs will be held in October 2013, the follow-up period will extend until June 2016.
Study objective
We hypothesize that multidisciplinary team training, to support implementation of a structured referral between obstetrical professionals, will result in better collaboration and thereby to a decrease in adverse perinatal outcomes
Study design
The intervention period, including the implementation and follow-up phase, takes 24 months for each LOC. For each LOC, five measurement periods are planned
Pre intervention: SAQ, IPCMS and patient satisfaction after intrapartum referral [timepoint: 3 months]
Post intervention: evaluation questionnaire [6 months], Vignettes study [ 6 / 24 months], Monitoring communication during referrals and measuring patient satisfaction after intrapartum referral [ 8 / 12 / 24 months], SAQ and IPCMS [ 12 / 24 months]
Continues data; Perinatal and maternal morbidity and mortality rates
Intervention
Five LOCs participate in the study intervention using a stepped wedge design. The intervention is a stepwise implementation programme of the SBAR (Situation - Background - Assessment - Recommendation) tool for structured referrals, using a multifaceted implementation strategy. A crucial part of the implementation strategy is a multidisciplinary team training based on crew resource management principles. The intervention period, including the implementation and follow-up phase, takes 24 months for each LOC. At 3-month time intervals a new LOC starts with the intervention.
M.C. Bruijne, de
EMGO Institute - VUmc | Department of public & occupational health Office C-570| Van der Boechorststraat 7
Amsterdam 1081 BT
The Netherlands
+31 20 4448166
mc.debruyne@vumc.nl
M.C. Bruijne, de
EMGO Institute - VUmc | Department of public & occupational health Office C-570| Van der Boechorststraat 7
Amsterdam 1081 BT
The Netherlands
+31 20 4448166
mc.debruyne@vumc.nl
Inclusion criteria
All patients of five Local Obstetrical Collaboratives (LOCs) in the Netherlands; Including all antenatal and perinatal unplanned referrals by primary care midwives to clinical care in a secondary or tertiary hospital after 22 weeks of gestation and up until 2 hours postpartum
Exclusion criteria
All antenal and perinatal unplanned patient referrals by primary care midwives to clinical care in a secondary or tertiary hospital before 22 weeks of gestation and more than 2 hours postpartum
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL4013 |
| NTR-old | NTR4256 |
| Other | ZonMw : 209020001 |
| ISRCTN | ISRCTN wordt niet meer aangevraagd. |