title: Use of social network analysis in maternity care to identify the profession most suited for case manager role.
abstract: OBJECTIVE
  To improve Dutch maternity care, professionals start working in interdisciplinary patient-centred networks, which includes the patients as a member. The introduction of the case manager is expected to work positively on both the individual and the network level. However, case management is new in Dutch maternity care. The present study aims to define the profession that would be most suitable to fulfil the role of case manager.
  
  
  METHODS
  The maternal care network in the Nijmegen region was determined by using Social Network Analysis (SNA). SNA is a quantitative methodology that measures and analyses patient-related connections between different professionals working in a network. To identify the case manager we focused on the position, reach, and connections in the network of the maternal care professionals.
  
  
  METHODS
  Maternity healthcare professionals in a single region of the Netherlands with an average of 4,500 births/year.
  
  
  METHODS
  The participants were 214 individual healthcare workers from eight different professions.
  
  
  RESULTS
  The total network showed 3948 connections between 214 maternity healthcare professionals with a density of 0.08. Each profession had some central individuals in the network. The 52 community-based midwives were responsible for 51% of all measured connections. The youth health doctors and nurses were mostly situated on the periphery and less connected. The betweenness centrality had the highest score in obstetricians and community-based midwives. Only the community-based midwives had connections with all other groups of professions. Almost all professionals in the network could reach other professionals in two steps.
authors.affiliation: Radboud university medical center, Department of Obstetrics and Gynaecology, Nijmegen, The Netherlands. Electronic address: carola.groenen@radboudumc.nl.
authors.forename: Carola J M
authors.initials: CJ
authors.lastname: Groenen
authors.affiliation: Radboud university medical center, Department of Obstetrics and Gynaecology, Nijmegen, The Netherlands. Electronic address: noortje.vanduijnhoven@radboudumc.nl.
authors.forename: Noortje T L
authors.initials: NT
authors.lastname: van Duijnhoven
authors.affiliation: Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands. Electronic address: marjan.faber@radboudumc.nl.
authors.forename: Marjan J
authors.initials: MJ
authors.lastname: Faber
authors.affiliation: Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands. Electronic address: jan.koetsenruijter@radboudumc.nl.
authors.forename: Jan
authors.initials: J
authors.lastname: Koetsenruijter
authors.affiliation: Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands. Electronic address: jan.kremer@radboudumc.nl.
authors.forename: Jan A M
authors.initials: JA
authors.lastname: Kremer
authors.affiliation: Radboud university medical center, Department of Obstetrics and Gynaecology, Nijmegen, The Netherlands. Electronic address: frank.vandenbussche@radboudumc.nl.
authors.forename: Frank P H A
authors.initials: FP
authors.lastname: Vandenbussche
mesh_terms: D000071959:Case Managers; D006282:Health Personnel / Q000145:classification*; D006801:Humans; D008427:Maternal Health Services; D009426:Netherlands; D018802:Patient-Centered Care; D012944:Social Support; D000078329:Workforce
keywords: Case manager; Community-based midwives; Maternity care; Social network analysis