Improving Safety on Labor and Delivery Through Team Huddles and Teamwork Training [25H]

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Abstract

INTRODUCTION:

Assess baseline and follow up safety culture data as well as outcome metrics on a Labor and Delivery Unit after the initiation of a patient safety program.

METHODS:

The Safety Attitudes Questionnaire (SAQ) has been widely validated in healthcare. This survey was distributed and collected from all professionals who work on the unit at the start of the intervention and fifteen months after; changes were assessed with the student t test. Clinical outcome measures were reviewed 12 months before initiation of the program and 15 months after using the chi-squared test. Twice-daily interdisciplinary safety huddles were initiated to discuss patients in active labor, high acuity antepartum, and postpartum patients. Four nursing centered teamwork-training sessions reviewed TeamSTEPPS principles, medication safety, and emergency scenarios. The Olive View Medical Center Institutional Review Board approved the study (#14E-LC1001).

RESULTS:

A total of 144 surveys were completed, 68 before and 76 after the intervention. Safety (P=.02), error management (P=.04), and safety practices (P=.03) demonstrated the most improvement overall. OB faculty also reported improvement in interactions with nursing (P=.02) and safety practices (P=.02). Other areas of improvement were L&D RN and OB faculty job satisfaction (P=.06 and .08), teamwork culture overall (P=.06); overall interactions with nursing (P=.06). No L&D outcome measures collected over the 26 month period demonstrated significant change.

CONCLUSION:

This study demonstrates that targeted improvements can make a difference in overall safety culture particularly in areas around safety, management of errors, and safety practices, but even extending to staff perceptions of job satisfaction and working conditions.

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