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Updated: Jun 9, 2025

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Published on: May 31, 2024
Bridging Perspectives, Building Resilience: Safety-II Guided Reflexive Dialogues Between Care Professionals and
Sarah R Lips1,2, Jolanda C G Boxem-Tiemessen2,3,4,5, Anna M Ligthart6
1Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Ethics, Law & Humanities, Amsterdam, The Netherlands.
Background:
Limitations of traditional structures and approaches to further enhance patient safety, satisfaction, and systemic sustainability in healthcare, are becoming increasingly visible. Embedding reflexivity is a proposed strategy to promote progress. We aimed to explore the potential of creating reflexive spaces for promoting integration and client-centeredness in maternity care specifically.
Methods:
In this participatory action research (PAR), two multidisciplinary and multiorganizational groups of maternity care professionals and clients (n = 28) from two Dutch regions, participated in 'reflexive dialogues'. Cases were discussed from a Safety-II perspective. In total, 22 meetings took place from 2020-2022, mostly online. Additionally, 23 participants were interviewed. Data were audio-recorded, transcribed, and thematically analyzed.
Findings:
Participants were generally positive about the reflexive dialogues and Safety-II approach. They felt both safe and challenged to critically reflect on their own and each other's care practices. Exchanging perspectives, experiences, and approaches fostered trust, well-being, and repertoire, and through this, resilience.
Conclusions:
By structurally stimulating, facilitating, and embedding Safety-II guided reflexive dialogues between professionals and clients from multiple organizations and disciplines, healthcare leaders could promote resilience and reinforce the transformation towards integrated, relation-centered maternity care.
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