Abstract:
In 2018, the Froedtert Health Birth Center experienced events that led to unexpected patient outcomes. The medical and nursing leadership team collaboratively worked together to identify process and practice issues, educational needs, and areas for improvement. They identified that one of the largest knowledge gaps among the obstetric care team was related to communication. The TeamSTEPPS Master Trainer program was identified as a tool that could assist in improving communication within the obstetric care team. Selected team members completed the TeamSTEPPS Master Trainer program in order to facilitate the TeamSTEPPS curriculum for the entire team. The implementation of the TeamSTEPPS program for the entirety of the Birth Center was a significant undertaking that included many meetings, educational sessions, and conferences. This also led to the development of a supplemental online curriculum. The leadership team recognized that practicing clinical scenarios was the best opportunity to incorporate the Team STEPPS communication tools.
The perfect venue for application of Team STEPPS tools was the Froedtert Simulation Center. In partnership with the Simulation Center team, the Birth Center Clinical Educators developed and designed multiple Obstetric Emergency Simulations. The topics over the past five years have ranged from hypertensive crisis leading to eclamptic seizure, magnesium sulfate toxicity, postpartum hemorrhage in a delivery room and postpartum, maternal sepsis, and emergent bedside cesarean section, maternal substance use disorder, and hypoglycemia. Offering the team members the opportunity to practice clinical skills while also practicing their communication tools have been a valuable use of time and resources.
The participants of the OB Emergency with Team STEPPS simulations have reported significant benefit to professional growth as a practitioner. The overall response has been extremely positive, with participants reporting an increase in confidence, competence, and knowledge after simulation-based education. While we cannot always decrease the overall postpartum hemorrhage rate by completing learning-based simulations, the teams have identified an improvement in response time and management to all types of obstetric emergencies. This has led to a considerable impact on patient care, related to overall management during obstetric emergencies. The communication tools have also empowered the nursing staff to advocate for their patients and utilize the multiple strategies to provide safe and efficient patient care.
The overall goal when implementing simulation-based education in obstetrics was to create a culture of safety within the team. By creating multiple emergent simulation experiences, the participants have gained insight into improved teamwork and communication while incorporating high-risk emergent situations. The evaluations for our simulation-based programming have been exceptionally positive. We have successfully created a safe, positive, and effective learning environment as evidenced by the improvements within the care team’s culture. The team is looking forward to the continued development of more obstetric simulations and the opportunity to enhance learning and patient outcomes in the future.
Learning Objectives:
- Identify why medical simulation-based learning is beneficial for obstetric team quality improvement initiatives.
- State the process of developing a training program that involves multiple stakeholders which includes meetings, design/development templates, and evaluations.
- Analyze the benefit of incorporating Team STEPPS communication tools in obstetric simulation experiences to promote quality and patient safety.
