Through the professional's eyes: transfers of care during pregnancy, childbirth and the postpartum period

Abstract

Background: In the Netherlands, the obstetric and neonatal healthcare system consists of multiple healthcare organizations. Due to this system, transfers between healthcare professionals are inevitable. Transfers can interrupt the continuity of care, which is an important aspect of care quality. The aim of this study is to examine how healthcare professionals transfer their clients and to understand factors that facilitate or impede continuity of care.

Methods: We conducted 15 semi-structured interviews with community midwives (4), obstetricians/clinical midwives (4), maternity care assistants (4), and youth healthcare nurses (3) between June and September 2016. After discussing the meaning of transfers of care, we introduced a vignette on the care process of a pregnant woman and asked about the methods the professional would use to transfer a client and about factors that facilitate or impede continuity of care.

Results: Obstetric and neonatal healthcare professionals mentioned 19 factors that facilitate or impede continuity of care. The facilitating factors were, e.g., usage of protocols and standard formats, transfers in person, being accessible, and multidisciplinary meetings. Impeding factors included, e.g., acute situations, experienced hierarchy, insufficient knowledge of protocols, and privacy concerns.

Conclusion: Professionals mentioned a broad variety of factors facilitating and impeding continuity of care.

Fig. 1

Vignette interview protocol

Fig. 2

Extended continuity of care model by Price and Lau [15]