Making shared care work: A national qualitative case study on collaborative practice in pediatric oncology
Year: 2026
Type: article
Abstract: Background In 2018, the Netherlands centralized all pediatric oncology care at the Prinses Máxima Center (Máxima), supported by a national network of 14 Shared Care centers. These centers deliver non-intensive treatment and supportive care closer to home, enabling a hybrid model of centralized expertise and regional accessibility. While structurally in place, little is known about how regional pediatricians experience this collaboration or which factors they consider essential to its success. Methods This national qualitative multiple case study explored interprofessional collaboration between the Máxima and its Shared Care partners, from the perspective of pediatricians in all 14 regional centers. Semi-structured interviews were conducted, transcribed, and analyzed inductively using ATLAS.ti. Analysis was informed by Kaats & Opheij's collaboration framework, encompassing shared ambition, mutual interests, interpersonal relationships, structured collaboration, and meaningful processes. Peer debriefing was used to enhance trustworthiness and ensure clinical relevance. Results Participants emphasized that close collaboration is indispensable for delivering safe, high-quality pediatric oncology care. Enabling factors included mutual trust, personal familiarity, timely and clear communication, and professional recognition. Challenges were identified in areas such as inconsistent policy implementation, opaque decision-making, and insufficient acknowledgment of local expertise. Many called for differentiated, context-sensitive care agreements rather than one-size-fits-all approaches. Conclusion Effective shared care requires more than structural alignment: it demands investment in professional relationships, shared goals, and adaptive processes. These findings offer actionable insights to improve collaboration within the Dutch model and provide transferable lessons for other countries navigating centralized care in highcomplex, low-volume pediatric specialties.
Source: EJC Paediatric Oncology
Authors: Natasja Dors, Martine van Grotel, Eline Zijtregtop, Nathalie van der Salm, Laura Keukens, Selma Lavrijssen, Charlotte Drykoningen, Anne Jonge Poerink, Rod Thompson, Jenneke Homan, Menco Weismuller, Wendy Nix, Hester Blufpand, Annemieke van der Wey, Daniëlle Martens, Marion Hekkelaan, Lotte Helder, Wouter Kollen, Max van Noesel, Marije P. Hennus
Institutions: Princess Máxima Center, Erasmus MC, University Medical Center Groningen, Frisius MC, Catharina Ziekenhuis, Ziekenhuis Gelderse Vallei, Medisch Spectrum Twente, VieCuri Medisch Centrum, Deventer Ziekenhuis, Dijklander Ziekenhuis, Admiraal De Ruyter Ziekenhuis, Amsterdam University Medical Centers, Jeroen Bosch Ziekenhuis, Isala, Reinier de Graaf Hospital, University Medical Center Utrecht, Wilhelmina Children's Hospital
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,340
OpenAlex ID: W7124143357