2008-02-22 / Community

Team Training For SJEH Maternity Unit

(Photo left) The Labor and Delivery staff at St. John's Episcopal Hospital gather twice a day around the patient progress monitor to improve communications among physicians, nurses, anesthesiologists, housekeepers and all disciplines as part of a new initiative to improve communications and coordination of care. Leading the team meeting is Jerald Korman, MD (center row, front), Chairman, Department of Obstetrics/Gynecology at St. John's. (Photo left) The Labor and Delivery staff at St. John's Episcopal Hospital gather twice a day around the patient progress monitor to improve communications among physicians, nurses, anesthesiologists, housekeepers and all disciplines as part of a new initiative to improve communications and coordination of care. Leading the team meeting is Jerald Korman, MD (center row, front), Chairman, Department of Obstetrics/Gynecology at St. John's. The healthy conclusion of a birth involves a host of healthcare professionals: obstetricians, nurses, anesthesiologists and pediatricians. The St. John's Episcopal Hospital Labor and Delivery unit - the unit where babies are actually delivered - is multidisciplinary. And, by its very nature, Labor and Delivery is a fast-moving, fast-changing unit with deliveries developing and evolving from hour to hour. Communication in this environment is not only a challenge, but a necessity. St. John's has the sole obstetrical service on the Rockaway Peninsula.

The staff on the Labor and Delivery unit saw a need to improve their interdisciplinary communication. "We looked to a program that RMF Strategies, a division of Risk Management Foundation of the Harvard Medical Institutions, Inc., developed called Team Performance Plus," says Jerald Korman, MD, Chairman of Obstetrics/- Gynecology. "What we liked about it is that members of our own staff were trained to become trainers enabling us to execute training on an ongoing basis."

The team training applies concepts used by military and commercial flight teams. Different tools are used to formalize a communications process by which all team members remain aware of the status of patients. "Now, through regular team meetings, anesthesiologists, for instance, are able to better adjust their schedules, improving patient care and reducing medical error," says Dr. Korman.

Dr. Korman, Arlette Bustamante, RN, Nurse Educator, Catherine Wieland, RN, Nurse Manager, and Arlene Falconer-Hill, Administrative Supervisor, attended an intensive three-day program, taught by Allan Frankel, MD, of Lotus Forum and Brigham and Women's Hospital in Boston. The St. John's foursome returned and trained the rest of the Labor and Delivery team.

The unit has launched regular team meetings. "Every day, twice a day at 9:30 a.m. and 9:30 p.m., representatives from all the disciplines meet to review the status of each case," says Ms. Bustamante. "We all are benefiting, including housekeepers, who sit in to understand what to expect of the next shift."

Once the team becomes adjusted to this culture change, new tools may be introduced, including briefing/debriefing systems and error-reduction techniques such as workload management, mutual support and cross-monitoring. Accountability systems will also be further refined to track whether and how teamwork is improving clinical outcomes. The team training initiative is just one of a number of new initiatives at St. John's aimed at improving quality of care and service.

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