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Tuesday, November 3, 2009
Learning Objective 1: The learner will be able to describe the process undertaken by Virtua Health to improve communication and teamwork on its two Labor & Delivery units.
Learning Objective 2: The learner will be able to identify some of the supportive and challenging aspects of undertaking this project in a large, multisystem hospital.
In recent reports released by the Joint Commission regarding infant and maternal deaths and injuries during delivery, communication issues were most often cited as the root cause. Additionally, organizational culture was identified as a barrier to effective communication and teamwork. The purpose of this project was to improve interdisciplinary collaboration in Labor & Delivery through the use of the SBAR (Situation-Background-Assessment-Recommendation) method of reporting, which has been described as one that bridges the gap in the differing communication styles of nurses and physicians, and the interdisciplinary performance of emergency mock drills. Surveys were administered to Labor & Delivery and Special Care Nursery staff nurses, OB/GYN physicians and midwives, anesthesiologists and nurse anesthetists, and neonatologists and neonatal nurse practitioners to inventory existing attitudes about communication and collaboration between the disciplines caring for the intrapartum patient. Education was completed on SBAR reporting and ultimately, mock emergency drills were conducted, incorporating the use of this format of reporting. The surveys were then readministered to measure any post-intervention change. Also discussed are the project's many challenging and supportive aspects including differing OB/GYN and Anesthesia staffs at each of two divisions, competition for nurses' time with respect to education, and involvement in the New Jersey Perinatal Collaborative, with congruent initiatives, during the course of the project.