A team approach to assisted conception treatment

A programme to improve 'continuity of care' was initiated at Bourn Hall Clinic in direct response to patient demand to see the same doctors and nurses throughout assisted conception treatment cycles. A working party comprising individuals from all disciplines involved in assisted conception care was set up to review practices and aims and to establish an action plan. As a result, in 1996, a team approach to in vitro fertilization (IVF) and frozen embryo transfer (FET) treatment cycles was introduced at the clinic. The nursing staff were divided into two teams, each with a leader, an appropriate skill mix of full- and part-time nurses, and one full-time and one relief doctor. Treatment cycles were scheduled using pituitary downregulation with gonadotrophin-releasing hormone (GnRH) agonist when appropriate, and a programme was devised in which groups of 40--45 couples started treatment during the same 5 day period. Each couple was assigned to one of the teams and starting dates for each group were separated by 2 week intervals. The objectives of the working party were successfully achieved. The team approach to treating a finite number of couples provides a better opportunity for individualized care. Couples appreciate the advantages of continuity of care and the improved rapport with team staff. Forward planning of treatment cycles provides greater flexibility for incorporating clinic visits into patients' normal routines. Staff have benefited from increased job satisfaction due to greater involvement with couples from initial contact to the completion of treatment. The new working practice provides opportunities for training and research. Staff costs have been rationalized with benefits both to couples and to the business unit.