Interdisciplinary Perinatal Care Implementation

Dutch perinatal care is provided interdisciplinary from two healthcare tiers: primary care by community midwives and maternity care organizations; and secondary/tertiary care by hospital employed care professionals. Hospitals, regional community midwife practices and maternity care organizations increasingly cooperate in OCN to provide continuity of care across pregnancy, childbirth and puerperium. In 2019, PROM/PREM implementation was initiated from a regional collaborative between ten OCN in the middle of the Netherlands, of which three OCN participated. In each OCN, the hospital and 2–4 midwifery practices implemented individual-level PROM/PREM in clinic. All other professionals working in the OCN (e.g., from other midwifery practices, maternity care organizations, youth care) could join network-broad QI with group-level outcomes. Each OCN had an interdisciplinary team in charge of implementation (including, at least one obstetrician, clinical midwife, and community midwife from each participating midwifery practice), of which one was appointed project leader. In this study, participants were defined as (1) professionals directly involved in implementation: project team members (key participants) or obstetricians/midwives using individual-level PROM/PREM, and (2) indirectly involved professionals: from other OCN-organizations or discipline, such as nurses. Patients were involved in implementation as they completed PROM/PREM for routine care but did not actively participate in this evaluation study. As patients had participated in our pre-implementation analysis and feasibility pilot [8 (link), 28 (link)], their needs were incorporated in the initial implementation strategy.