There is a growing attention in the Netherlands to develop palliative care facilities of high quality, fulfilling the needs of the patients. This development is influenced by the growing number of aged people and changing societal ideas about death and dying. Palliative care should be developed within the existing health care structure. This policy created the need for regional centers and networks to stimulate the palliative care, focussing at studies on the organization of the health care. The development and evaluation of palliative networks has been studied in order to raise the quality of the care in the region of Rotterdam. In this qualitative and descriptive study we follow the development of the networks. As sources are used: literature on networks in health care, documents of the networks, and interviews with the coordinators.
A survey (n=60) has been held aiming at all participants in seven palliative networks about success and failure factors influencing the results of the networks. The studied factors concern structural characteristics of the networks, aims and decision making, and cooperation processes.
Out-come variables are the quality of the cooperation, and the perceived quality and type of care. Results show a great variety of networks in palliative care with a diversity of aims. The questionnaire study revealed a variety of potential factor influencing the quality of care: power-relations, cooperation within and between networks, work satisfaction, understanding for referrals, knowledge and skills. In a follow-up study three networks are studied in depth. The conclusion is that network analysis is an important means to study success and failure factors in order to improve the quality of palliative care.