Maastricht, Limburg, Netherlands
In my work I find quality one of the most important goals, both in a direct and indirect way. In everyday practice I try to give the best possible care to give maximal personal attention to individual patients. With high level care when needed, but without losing the awareness that social interaction in pregnancy is equally as important as well. My earlier research focussed on implementation research on quality of care and evaluation of every day medical obstetrical care. More recent my focus lies on individualized care combining prediction models on individual outcomes with shared decision making. I believe that randomized trials result in one size fits all results and these are of limited value. Our model on delivery after a previous caesarean section and the implementation of first trimester risk assessment combined with individual care pathways have resulted in both improvement of care, lowering of costs and a higher patient involvement. Specialties: perinatology, high risk pregnancies
Besides clinical work in perinatal medicine my focus is on quality of care. I am an active member of both the Dutch Obstetrical Research Consortium, chair of the Limburg Perinatal Audit and member of the Dutch Guideline committee. I have been co promotor of Carolien Roos (APOSTEL II trial on sustained tocolyses), Mallory Woiski (FLUXIM trial on guideline adherence and development of implementation strategy on postpartum haemorrhage), Ellen Schoorel (SIMPLE trial: prediction and counselling in women with previous caesarean section) and Linda Meertens (EXPECT trial: predicting adverse outcome in first trimester). Currently ungoing thesis: Sonja Melman and Emy Vankan: SIMPLE trial, Suzan de Visser (FLUXIM trial), Pim Schol and Natasha de Lange (ROTEM and REFILL: fluid management and homeostasis in postpartum haemorrhage), Adrie Lettink (CC trial: cost effectiveness of continious care by Kraamzorg) Pim van Montfoort (EXPECT II: evaluation risk based obstetrical care), Jessica Wilms (calcium intake during pregnancy) and Stephanie Lemmens (development of multidisciplinary care pathways in obstetrics) With a ZONMW grant we have founded the LOQS (limburg obstetrical quality system), a cooperation of all the VSV's in Limburg. We have developed care pathways that combined with a prediction model on adverse outcome results in risk based care. Current evaluation on both outcome, patient satisfaction and cost effectiveness is un going. The LOQS is linked to the perinatal Audit and current developments include the development of "kenniswerkplaats Jeugd", a cooperation between all social, political, educational and medical stakeholders to the tackle disadvantaged health status of the Limburg population.
gynaecologist
Residency and scientific Research resulting in a PhD thesis