• teamwork;
  • safety;
  • communication

Poster Presentation

  1. Top of page
  2. Poster Presentation

Purpose for the Program

Teamwork and effective communication have a profound effect on patient care; in the delivery room this means the best possible care for mothers and infants. With that goal in mind, our obstetrics team implemented a crew resource management initiative. Although the principles of crew resource management are relatively new to the health care environment, the literature supports the value of training health care teams in the principles of crew resource management.

Proposed Change

The goal of the initiative was to improve patient care through improved communication between and among disciplines; situation monitoring throughout the continuum of care; and mutual support and respect among care givers and effective team leadership.

Implementation, Outcomes, and Evaluation

A mandatory crew resource management training program was presented to all staff members of labor and delivery, all attending anesthesiologists and obstetricians, nursing leadership, the neonatology director, and neonatal nurse practitioners. Through team meetings and debriefings, we identified areas in which patient care could be improved. For example, a team debriefing that followed a stat cesarean birth precipitated several changes. Among these changes was a revision of the method used to track calls from physicians’ offices as well as the information recorded by nursing staff regarding the location of covering physicians. This translated into the nursing staff being aware of the physician's plan of care for each patient even before that patient's arrival in labor and delivery. It also triggered a collaborative effort between the departments of anesthesia and nursing education to provide in-service education to labor and delivery nursing staff and to review the nurse's role in assisting with general anesthesia. Medical records of mothers and newborns were analyzed to determine the incidence and significance of the 10 adverse outcomes identified by Mann et al. prior to and following crew resource management training.

Implications for Nursing Practice

Expecting health care professionals to work as a team has enhanced performance and improved outcomes for mother and infant. Improved communication with the nurses on the maternity unit has smoothed the transition of patient care between departments. Since the completion of training and initiation of team meetings, we realized a significant improvement in both the incidence and severity of adverse outcomes following the crew resource management training as well as a significant improvement in employee satisfaction.