Background: Although network formation is considered an effective method of stimulating
the integrated delivery of palliative care, scientific evidence on the usefulness of network formation
is scarce. In 1998 the Ministry of Health of The Netherlands started a 5-year stimulation
program on palliative care by founding and funding six regional Centres for the Development
of Palliative Care. These centers were structured around pivotal organizations such
as university hospitals and comprehensive cancer centers. As part of the stimulation program
a locoregional network model was introduced within each center for the Development of Palliative
Care to integrate palliative care services in the Dutch health care system.
Objective: We performed a study on network formation in the southwestern area of The
Netherlands with 2.4 million inhabitants. The study aimed to answer the following questions:
(1) how do networks in palliative care develop, which care providers participate and how do
they function? (2) which are the achievements of the palliative care networks as perceived by
their participants? (3) which are the success factors of the palliative care networks according
to their participants and which factors predict the achievements?.
Design: Between September 2000 and January 2004 eight local palliative care networks in
the region of the Center for Development of Palliative Care-Rotterdam (southwestern area of
The Netherlands) were closely followed to gain information on their characteristics and developmental
course.
Measurements: At the start of the study semistructured interviews were held with the coordinators
of the eight networks. The information from these interviews and from the network
documents were used to constitute a questionnaire to assess the opinions and experiences
of the network participants.
Results: According to the vast majority of responders, the most important reason to install
the networks was the lack of integration between the existing local health care services. The
networks were initiated to stimulate mutual collaboration, improve accessibility to health care
services and increase the quality of these services. The most important achievements obtained
by the palliative care networks were: increase in personal contacts between colleagues in a region, improved engagement and collaboration between participating organizations, enhanced
insight in the health care provisions, joined initiatives for the development of new
care products, and organization of patient-tailored care. Important success factors for the networks
were deemed: fruitful mutual contacts, regular funding and the collective development
of care products. By logistic regression analyses, the collective development of new care products
and the organization of case discussions between caregivers from different health care
services turned out to be the most important predictors for success of the palliative care networks.
Conclusions: Projects that stimulate the communication between professionals appear to
improve the mutual collaboration between individual participants and between the participating
organizations, which consequently enhances the quality of palliative care.
