Impact of simulation and team training on postpartum hemorrhage management in non-academic centers

Marshall, Nicole; Vanderhoeven, Jeroen; Eden, Karen; Segel, Sally; Guise, Jeanne Marie

doi:10.3109/14767058.2014.923393

Cited by 60 publications

(47 citation statements)

References 17 publications

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“…37 Table 4 lists innovations that have been used to recruit, train, and support those who choose to practice in rural settings. 36,[38][39][40][41][42][43][44][45][46][47][48][49] Nearly all of these programs require funding and collaboration with stakeholders such as communities or the government in order to be successful in addressing maternal health disparities in rural populations.…”

Section: Special Articlementioning

confidence: 99%

“…Teamwork training in a simulation setting to improve knowledge, practical skills, communication, and performance in acute obstetric situations Implementation of team behaviors to reduce medical errors and improve patient safety 48,49 the other hand, the extreme joy of participating in births and the continuity of care that doing so offers is an emotion that often sustains FP maternity care providers in their work. There was a strong opinion among workshop attendees that intentionally creating specific professional support around bad outcomes while celebrating the unique joys of providing intrapartum care and sharing this support with learners may help to support FP maternity care providers to continue to practice while inspiring a new generation.…”

Section: Team-based Training and Simulationmentioning

confidence: 99%

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Supporting Family Physician Maternity Care Providers

Goldstein

Hartman

Meunier

et al. 2018

Fam Med

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Maternity care access in the United States is in crisis. The American Congress of Obstetrics and Gynecology projects that by 2030 there will be a nationwide shortage of 9,000 obstetrician-gynecologists (OB/GYNs). Midwives and OB/GYNs have been called upon to address this crisis, yet in underserved areas, family physicians are often providing a majority of this care. Family medicine maternity care, a natural fit for the discipline, has been on sharp decline in recent years for many reasons including difficulties cultivating interdisciplinary relationships, navigating privileging, developing and maintaining adequate volume/competency, and preventing burnout. In 2016 and 2017, workshops were held among family medicine educators with resultant recommendations for essential strategies to support family physician maternity care providers. This article summarizes these strategies, provides guidance, and highlights the role family physicians have in addressing maternity care access for the underserved as well as presenting innovative ideas to train and retain rural family physician maternity care providers. (Fam Med. 2018;50(9):662-71.)

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Section: Special Articlementioning

confidence: 99%

Section: Team-based Training and Simulationmentioning

confidence: 99%

Supporting Family Physician Maternity Care Providers

Goldstein

Hartman

Meunier

et al. 2018

Fam Med

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“…Teamwork training in a simulation setting improved knowledge, practical skills, communication, and team performance in acute obstetric situations in 7 studies 29 and improved perinatal outcomes in 3 studies. [29][30][31] Obstetric simulation training initiatives have been successfully implemented in rural hospitals in Wisconsin 32 and Oregon 33 with funding from the Health Resources and Services Administration and the Agency for Healthcare Research and Quality, respectively. Many hospitals in our survey reported participating in obstetric quality improvement and patient safety initiatives in partnership with hospital networks, hospital systems, state hospital associations, state health departments, or other private and public partners.…”

Section: Maintaining Skills In Low-birth-volume Settingsmentioning

confidence: 99%

The Rural Obstetric Workforce in US Hospitals: Challenges and Opportunities

Kozhimannil

Casey

Hung

et al. 2015

The Journal of Rural Health

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Purpose The purpose of this study was to describe the types and combinations of clinicians who are delivering babies in rural hospitals, their employment status, the relationship between hospital birth volume and staffing models, and the staffing challenges faced by rural hospitals. Methods We conducted a telephone survey of 306 rural hospitals in 9 states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin, from November 2013-March 2014 to assess their obstetric workforce. Bivariate associations between hospitals’ annual birth volume and obstetric workforce characteristics were examined, as well as qualitative analysis of workforce changes and staffing challenges. Findings Hospitals with lower birth volume (< 240 births per year) are more likely to have family physicians and general surgeons attending deliveries, while those with a higher birth volume more frequently have obstetricians and midwives attending deliveries. Reported staffing challenges include scheduling, training, census fluctuation, recruitment and retention, and intra-hospital relationships. Conclusions Individual hospitals working in isolation may struggle to address staffing challenges. Federal and state policy makers, regional collaboratives, and health care delivery systems can facilitate solutions through programs such as telehealth, simulation training, and interprofessional education.

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“…Moreover, an intervention study in the United States showed improved response times related to PPH management among experienced clinical teams. This was an important finding, because time delay in identification and treatment of PPH can cause a deterioration of the mother’s condition within minutes [15]. Simulation training could help improve response times.…”

Section: Introductionmentioning

confidence: 99%

“No patient should die of PPH just for the lack of training!” Experiences from multi-professional simulation training on postpartum hemorrhage in northern Tanzania: a qualitative study

Egenberg

Karlsen

Massay³

et al. 2017

BMC Med Educ

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BackgroundPostpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. In Tanzania, PPH causes 25% of maternal deaths. Skilled attendance is crucial to saving the lives of mothers and their newborns during childbirth.This study is a follow-up after multi-professional simulation training on PPH in northern Tanzania. The purpose was to enhance understanding and gain knowledge of important learning features and outcomes related to multi-professional simulation training on PPH.MethodsThe study had a descriptive and exploratory design. After the second annual simulation training at two hospitals in northern Tanzania, ten focus group discussions comprising 42 nurse midwives, doctors, and medical attendants, were carried out. A semi-structured interview guide was used during the discussions, which were audio-taped for qualitative content analysis of manifest content.ResultsThe most important findings from the focus group discussions were the importance of team training as learning feature, and the perception of improved ability to use a teamwork approach to PPH. Regardless of profession and job tasks, the informants expressed enhanced self-efficacy and reduced perception of stress. The informants perceived that improved competence enabled them to provide efficient PPH management for improved maternal health. They recommended simulation training to be continued and disseminated.ConclusionLearning features, such as training in teams, skills training, and realistic repeated scenarios with consecutive debriefing for reflective learning, including a systems approach to human error, were crucial for enhanced teamwork. Informants’ confidence levels increased, their stress levels decreased, and they were confident that they offered better maternal services after training.

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Impact of simulation and team training on postpartum hemorrhage management in non-academic centers

Abstract: Simulation and team training significantly improved postpartum hemorrhage response times among clinically experienced community labor and delivery teams.

Cited by 60 publications

References 17 publications

Supporting Family Physician Maternity Care Providers

Supporting Family Physician Maternity Care Providers

The Rural Obstetric Workforce in US Hospitals: Challenges and Opportunities

“No patient should die of PPH just for the lack of training!” Experiences from multi-professional simulation training on postpartum hemorrhage in northern Tanzania: a qualitative study

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