Interdisciplinary team training with in-situ simulation helps reduce adverse events in obstetric patients
Research Activities, January 2012, No. 377
Labor and delivery units in hospitals are challenging, high-stress environments where birth trauma is a low-frequency but high-severity event. The most common cause of these events is communication failure. A new study shows that interdisciplinary team training that focuses on cognitive and interpersonal skills, along with simulated scenarios, can have a significant and persistent improvement on perinatal morbidity.
The researchers looked at deliveries at three community hospitals that accounted for approximately 1,800 deliveries each year. One hospital served as the usual-care control. A second hospital received the TeamSTEPPS® didactic training program. Finally, the third hospital received intensive training that combined TeamSTEPPS with in-situ simulation training exercises. TeamSTEPPS consists of a curriculum that focuses on leadership, situation monitoring, mutual support, and communication. The in-situ training consisted of real-life scenarios covering uterine rupture, placental abruption, and post-partum hemorrhage.
Only the TeamSTEPPS-simulation program resulted in a 37 percent improvement in perinatal morbidity. No significant differences were found between the control hospital and the hospital receiving just the didactic curriculum training. There were no significant improvements on culture of safety perceptions as a result of the trainings. However, perceptions of safety were already high at all three hospitals prior to the study. The study was supported in part by the Agency for Healthcare Research and Quality (HS16728).
See "Didactic and simulation nontechnical skills team training to improve perinatal patient outcomes in a community hospital," by William Riley, Ph.D., Stanley Davis, M.D., Kristi Miller, R.N., M.S., and others in the August 2011 issue of The Joint Commission Journal on Quality and Patient Safety 37(8), pp. 357-364.