Stakeholders' opinions on the implementation of Child Death Review in the Netherlands.
BACKGROUND
The death of a child is an enormous tragedy for both the family and others involved. A child's death appeals to everyone's responsibility to take measures to prevent similar deaths in the future. Child Death Review (CDR) is an interagency approach in which a child's death is systematically analyzed by a multidisciplinary team. The aim of CDR is to identify avoidable factors that give direction to prevention and to improve death statistics. CDR is not yet implemented in the Netherlands. The purpose of this study is to determine Dutch stakeholders' opinions regarding the facilitating and impeding factors in the implementation of CDR in the Netherlands.


METHODS
Four focus groups were conducted: three with professionals who are involved in children's deaths and one with parents who have lost a child under the age of 2 years. The recorded discussions were transcribed and analyzed using Atlas ti. The facilitating and impeding factors were measured using the measurement instrument for determinants of innovations (MIDI). The MIDI identifies facilitating and impeding determinants associated with the innovation, user, organization and social-political context.


RESULTS
Improvement of the quality of (health) care and obtaining a clear explanation for the child's death (user and innovation) were identified as benefits of CDR. The emotional burden for professionals and parents and the time implications were considered to be drawbacks of CDR (user and innovation). The multidisciplinary approach (innovation), parental consent and the use of anonimyzed data (user) were considered as facilitators to implementation. Insufficient information (innovation), potential legal consequences for professionals and organizations (user), insufficient ratification by organizations (organization) and confidentiality (social-political context) were identified as impeding implementation.


CONCLUSIONS
The determinants identified as facilitating and the recommendations provided to overcome the barriers can be used as input for the strategy for implementation of CDR. A pilot study is necessary to determine to what extent the chosen implementation strategy is effective.
Department HTSR, IGS Institute for Innovation and Governance Studies, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands. s.gijzen@utwente.nl.
Sandra
S
Gijzen
TNO Child Health, P.O. Box 2215, 2301 CE, Leiden, The Netherlands.
Monique P
MP
L'Hoir
Department HTSR, IGS Institute for Innovation and Governance Studies, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands.
Magda M
MM
Boere-Boonekamp
Department Public Administration, IGS Institute for Innovation and Governance Studies, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands.
Ariana
A
Need
D000061:Accidents, Home / Q000517:prevention & control; D002423:Cause of Death; D002662:Child Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D046688:Child Mortality; D002675:Child, Preschool; D005190:Family / Q000523:psychology; D005260:Female; D017144:Focus Groups; D006117:Grief; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands; D009937:Organizational Objectives; D010290:Parents / Q000523:psychology; D036301:Qualitative Research
Child Death Review; Child mortality; Implementation; Prevention