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
Keywords: Communication, Safety, Obstetrics