Download PDF
CC BY-NC-ND 4.0 · AJP Rep 2017; 07(01): e44-e48
DOI: 10.1055/s-0037-1599123
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Opportunities to Foster Efficient Communication in Labor and Delivery Using Simulation

Kay Daniels
1   Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
2   Department of Pediatrics, Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California
,
Colleen Hamilton
2   Department of Pediatrics, Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California
,
Susan Crowe
1   Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
2   Department of Pediatrics, Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California
,
Steven S. Lipman
2   Department of Pediatrics, Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California
3   Department of Anesthesiology, Pain and Perioperative Medicine, Stanford University School of Medicine, Stanford, California
,
Louis P. Halamek
2   Department of Pediatrics, Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California
4   Department of Pediatrics, Stanford University School of Medicine, Stanford, California
,
Henry C. Lee
2   Department of Pediatrics, Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California
4   Department of Pediatrics, Stanford University School of Medicine, Stanford, California
› Author Affiliations
Further Information

Publication History

04 August 2016

09 January 2017

Publication Date:
28 February 2017 (online)

   Permissions and Reprints

Abstract

Introduction Communication errors are an important contributing factor in adverse outcomes in labor and delivery (L&D) units. The objective of this study was to identify common lapses in verbal communication using simulated obstetrical scenarios and propose alternative formats for communication.

Methods Health care professionals in L&D participated in three simulated clinical scenarios. Scenarios were recorded and reviewed to identify questions repeated within and across scenarios. Questions that were repeated more than once due to ineffective communication were identified. The frequency with which the questions were asked across simulations was identified.

Results Questions were commonly repeated both within and across 27 simulated scenarios. The median number of questions asked was 27 per simulated scenario. Commonly repeated questions focused on three general topics: (1) historical data/information (i.e., estimated gestational age), (2) maternal clinical status (i.e., estimated blood loss), and (3) personnel (i.e., “Has anesthesiologist been called?”).

Conclusion Inefficient verbal communication exists in the process of transferring information during obstetric emergencies. These findings can inform improved training and development of information displays to improve teamwork and communication. A visual display that can report static historical information and specific dynamic clinical data may facilitate optimal human performance.

Keywords

communication - health care professionals - labor and delivery - simulation
 

  • References

  • 1 Pettker CM, Grobman WA. Obstetric safety and quality. Obstet Gynecol 2015; 126 (01) 196-206
    CrossrefPubMedGoogle Scholar
  • 2 Preventing infant death and injury during delivery. Jt Comm Perspect 2004; 24 (09) 14-15
    PubMedGoogle Scholar
  • 3 Lisbon D, Allin D, Cleek C. , et al. Improved knowledge, attitudes, and behaviors after implementation of TeamSTEPPS training in an academic emergency department: a pilot report. Am J Med Qual 2016; 31 (01) 86-90
    CrossrefPubMedGoogle Scholar
  • 4 Sawyer T, Laubach VA, Hudak J, Yamamura K, Pocrnich A. Improvements in teamwork during neonatal resuscitation after interprofessional TeamSTEPPS training. Neonatal Netw 2013; 32 (01) 26-33
    CrossrefPubMedGoogle Scholar
  • 5 Weld LR, Stringer MT, Ebertowski JS. , et al. TeamSTEPPS improves operating room efficiency and patient safety. Am J Med Qual 2016; 31 (05) 408-414
    CrossrefPubMedGoogle Scholar
  • 6 Mayer CM, Cluff L, Lin WT. , et al. Evaluating efforts to optimize TeamSTEPPS implementation in surgical and pediatric intensive care units. Jt Comm J Qual Patient Saf 2011; 37 (08) 365-374
    PubMedGoogle Scholar
  • 7 Mann S, Pratt SD. Team approach to care in labor and delivery. Clin Obstet Gynecol 2008; 51 (04) 666-679
    CrossrefPubMedGoogle Scholar
  • 8 Weller JM, Torrie J, Boyd M. , et al. Improving team information sharing with a structured call-out in anaesthetic emergencies: a randomized controlled trial. Br J Anaesth 2014; 112 (06) 1042-1049
    CrossrefPubMedGoogle Scholar
  • 9 Brindley PG, Reynolds SF. Improving verbal communication in critical care medicine. J Crit Care 2011; 26 (02) 155-159
    CrossrefPubMedGoogle Scholar