Improving communication between obstetric and neonatology teams for high-risk deliveries: a quality improvement project

Abstract

Summoning is a key component of communication between obstetrics and neonatal resuscitation team (NRT) in advance of deliveries. A paging system is a commonly used summoning tool. The timeliness and information contained in the page help NRT to optimally prepare for postdelivery infant care. Our aim was to increase the frequency that summoning pages contained gestational age and reason for NRT attendance to >90%. At baseline, 8% of pages contained gestational age and 33% of pages contained a reason for NRT attendance. Sequential Plan-Do-Study-Act cycles were used as our model for quality improvement. During the 8-month improvement period, the per cent of pages increased to 97% for gestational age and 97% for reason for NRT attendance. Measures of page timeliness, our balancing measure, did not change. Summoning communication between obstetric and NRT is crucial for optimal perinatal outcomes. The active involvement of all stakeholders throughout the project resulted in the development of a standardised paging tool and a more informative paging process, which is a key communication tool used in many centres.

Interdisciplinary handover between obstetric nursing and neonatal physician teams: an observational study

“…Recent research reports have suggested that missing information regarding one or more of the core content elements can potentially cause adverse outcomes for the newborn and/or the mother 17 18. To identify missing elements, after all handovers were coded using the clinical content framework, we evaluated each handover for content completeness and content relevance .…”

Ergonomic Challenges Inherent in Neonatal Resuscitation

“…However, there can be significant practice variation between and even within centers regarding how the neonatal resuscitation team is activated. For example, prior to the implementation of a quality improvement effort aimed at improving this communication, one center identified that only 8% of pages to the neonatal resuscitation team contained the fetus’ gestational age and just 33% of pages contained the reason for requesting the neonatal resuscitation team [43]. The process that resulted from this quality improvement work included a number of systems-based strategies to improve communication between the obstetric team and the neonatal resuscitation team, including the training of staff, a decrease in the number of categories of information that were transmitted, and the implementation of a software-based program to aid standardized information gathering and dissemination [43].…”