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Optimisation of natal care: structure or culture

Improvement is complicated, particularly without cause

In recent years there has been a great deal of criticism natal care in the Netherlands. Quality must be increased in order to reduce perinatal mortality. Although everyone naturally agrees with this, changes in this healthcare sector are not simple, due to its complex, multidisciplinary character.

A large hospital recognises the need for improvement, despite the fact that patient satisfaction remains high. Natal care is not satisfactory to healthcare professionals, but the cause of this is unclear.

Nine months to optimise natal care

It soon became apparent that the challenges were both technical (processes) and cultural in nature. Our approach was therefore aimed at identifying the bottlenecks in all of the disciplines, and developing an improvement plan based on this.
Together with a working group composed of 15 people from all job levels and departments, we developed a plan to improve healthcare for both mother and child. We did this based on a vision that had been jointly formulated beforehand. Important subjects that we dealt with concerned file management (during pregnancy), transfer (during the birth), communication and outpatient processes.

A good result, a difficult delivery

By working together intensively for nine months, we were able to substantively improve some concrete themes. This increases the safety of mother and child in the short term, and is a good first step.

The great benefit, however, is in decreasing the distance between all those involved. This was not a simple process: when professionals from different backgrounds speak out, differences come to light. Although guiding such a process is not always a pleasant task, it did contribute to a better mutual understanding, improved work agreements and therefore, better natal care.

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