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Creating a Highly Reliable Perinatal Service Natividad Medical Center Salinas, Ca

Creating a Highly Reliable Perinatal Service Natividad Medical Center Salinas, Ca. Multidisciplinary team at morning hand off. Communication- our quest is to be a team that has a shared understanding of what is going on.

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Creating a Highly Reliable Perinatal Service Natividad Medical Center Salinas, Ca

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  1. Creating a Highly ReliablePerinatal ServiceNatividad Medical CenterSalinas, Ca Multidisciplinary team at morning hand off

  2. Communication- our quest is to be a team that has a shared understanding of what is going on • Communication is an essential component of perinatal teamwork and has a significant impact on the risk of adverse outcomes • We use consistent and mutually agreed upon language to describe FHR patterns and to develop mutually expected interventions based on those patterns- NICHD terminology

  3. Formal Briefings at designated Times: 0800; 1130; 1700; 2300 Sets the tone for the day Discuss procedures, unexpected changes in the care process Everyone knows the game plan, we are on the same page Make sure the situation is owned by the entire team The team includes oncoming and outgoing Family Medicine and OB, residents, L&D RNs, The L&D Charge RN and the Mother/Baby Unit charge RN

  4. Provide meaningful background, stick to facts Talk about next steps Encourage ongoing monitoring & cross-checking: it’s everyone’s responsibility to maintain situational awareness Formal Briefings at Designated Times

  5. Off going OB getting ready for board rounds L&D RN Oncoming OB OR duty Supervising RN – L&D OB in clinic Mother/Baby Charge RN Sleepy resident Charge RN – L&D

  6. OB physician Family Medicine physician L&D RN

  7. Oncoming OB CRNA On for 24 hrs 1styear resident Off going OB

  8. “Let me tell you about last night!”

  9. Five Components to Multidisciplinary Rounds • Timely briefings: 0800; 1100; 1700; 2300 • Courtesy • Review labor curve • Clear Communication: • SBAR • “I need clarity” – used to stop an event or clarify plan of care • Consistent use of NICHD terminology when reviewing FHR during board rounds

  10. Natividad’s Process • All team members gather on time • Each patient’s case is discussed, the FHR monitor strip is reviewed using NICHD terminology • Be brief, complete, RN shares current information with team • Even the private physicians present their patients as part of the team and review the fetal monitor strip

  11. Even the private physicians attend board rounds and report on their patients. We are all on the same page

  12. Keeps track of each member that attends board rounds Documents the category of each strip reviewed Labor and Delivery Charge RN

  13. Commitment • The entire team is committed to being a part of the communication process • Efficient situational awareness is owned and practiced by the entire perinatal team • On-going updates, cross-talk, cross-checks, verifying that the entire team knows what is happening • The entire team knows what should happen next

  14. Our champion – Dr Peter Chandler

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