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Improving communication and cooperation between obstetrical professionals in the Netherlands


- candidate number15629
- NTR NumberNTR4256
- ISRCTNISRCTN wordt niet meer aangevraagd.
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR28-okt-2013
- Secondary IDs209020001  ZonMw
- Public TitleImproving communication and cooperation between obstetrical professionals in the Netherlands
- Scientific TitleImproving obstetrical care by multidisciplinary team training for patient referral situations
- ACRONYMLOCoMOTive study: Local Obstetrical Collaboration Multidisciplinary On-site Team training effectiveness
- hypothesisWe 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
- Healt Condition(s) or Problem(s) studied
- Inclusion criteriaAll 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 criteriaAll 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
- mec approval receivedyes
- multicenter trialyes
- randomisedyes
- masking/blindingNone
- controlNot applicable
- group[default]
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 1-nov-2013
- planned closingdate1-jul-2016
- Target number of participants10000
- InterventionsFive 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.
- Primary outcomePerinatal 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
- TimepointsThe 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
- Trial web siteN/A
- statusplanned
- CONTACT FOR PUBLIC QUERIES M.C. Bruijne, de
- CONTACT for SCIENTIFIC QUERIES M.C. Bruijne, de
- Sponsor/Initiator VU University Medical Center
- Funding
(Source(s) of Monetary or Material Support)
ZON-MW, The Netherlands Organization for Health Research and Development
- PublicationsN/A
- Brief summaryThe 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.
- Main changes (audit trail)
- RECORD28-okt-2013 - 23-dec-2013


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