Background: ACGME milestones for resident education in obstetrics and gynecology include resident participation in departmental or institutional quality improvement and safety initiatives. Given the current multidisciplinary model of health care delivery, it is especially important that residents learn to work well and effectively with other members of the collective team. On Labor and Delivery this is especially important as effective communication is essential to achieving the best outcome for mothers and their unborn infants.
Methods: The Safety Attitudes Questionnaire® was given to all members of Labor and Delivery. Team members then participated in Fetal Heart Tracing Rounds during Ob/Gyn Resident Education time. After 4 sessions, the questionnaire was redistributed and answers were compared using the Cochran-Armitage Trend Test. The patient responses were measured through a Press Ganey® satisfaction survey.
Results: Communication improved between nurse to nurse (p = 0.005) and nurse to OB Resident (p = 0.0256). Communication improvement between Family Medicine and OB Resident nearly achieved statistical significance (p = 0.074). Patient survey responses indicate a perceived improvement in communication among physician and nursing teams.
Discussions: Communication failure is identified in a high proportion of sentinel events. Data gained from this study indicate that communication among providers in intrapartum care can be improved with implementation of multidisciplinary fetal heart tracing rounds. Long-term goal of this initiative will be to correlate improvement in communication among Labor and Delivery care providers with a decrease in adverse maternal and fetal events.
Keywords: Communication, Safety, Obstetrics
Topics: CREOG & APGO Annual Meeting, 2016, Student, Resident, Faculty, Residency Director, Patient Care, GME, Problem-Based Learning, Team-Based Learning, Maternal-Fetal Medicine,
Heather Williams, MD, Univ of Iowa Hospital & Clinics; Marygrace Elson, MD, MME; Amy Sanborn, RN, DNP, C-EFM