November 19, 2019

Severe postpartum hemorrhage is a leading cause of morbidity and mortality for women in the United States.  Expert management requires a coordinated effort from obstetrics, obstetric anesthesia, and nursing staff.

A Graduate Medical Education curriculum course for postpartum hemorrhage has been designed to teach residents  from multiple disciplines how to communicate effectively and work as a cohesive team. This initiative is designed to reinforce best practice management protocols and is part of a national strategy championed by obstetric anesthesia, obstetrics, and mother-baby nursing staff.

Laurie DeSantis, CNM, Quality and Safety Advisor for Women’s Health, said The Joint Commission, the Institute for Healthcare Improvement and the Agency for Healthcare Research and Quality have all endorsed simulation training, especially in critical care areas such as obstetrics, ICUs and Emergency Departments.

Jeanette Bauchat, MD, Chief of the Division of Obstetric Anesthesiology, said that there is evidence that maternal and fetal morbidity and mortality is reduced when multidisciplinary teams on labor and delivery work together and simulate and practice obstetric emergency drills. “In simulation, crisis management techniques can be practices where the stakes are much lower than an actual maternal emergency,” she said.

This training will help prepare clinicians for real-life emergencies in obstetrics, explained Garrison Etoi, Director of Obstetric Simulation and Education, who helped to develop and implement the curriculum. She said even though the training is for residents, it gives every member of the team from attendings to nurses an opportunity for practice-based learning in a safe environment.  Garrison emphasized the importance of recognizing everyone who contributed to the success of making these training sessions happen. She explained it is important to note this was a truly a multidisciplinary effort.

This training will help the whole team to improve teamwork and communication. According to Bauchat, studies have shown that not only does team training improve people’s performance in an actual emergency, it improves safety culture. She explained that when teams have worked together before in a simulation situation, it improves their communication in the future because they are more comfortable communicating.

DeSantis explained that during simulation training, they have started to identify issues that cause delays in patient care and have already begun to make changes to the process. “I’m excited that our simulation training has led us to making improvements that will directly impact patient care on the obstetric units,” she said.

Bauchat said this training will allow obstetric emergency response team to respond faster, more efficiently and more effectively. “The hope is that you are catching hemorrhage earlier and treating it faster so women don’t need as many transfusions, so they don’t lose too much blood or need a hysterectomy,” she said.

Garrison emphasized the importance of recognizing everyone who contributed to the success of making these training sessions happen. She explained it is important to note this was a truly a multidisciplinary effort.