Journal for healthcare quality : official publication of the National Association for Healthcare Quality
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Effective communication and teamwork among the healthcare team has a profound impact on patient care; in the Delivery Room it means the best possible outcome for moms and babies. With that goal in mind, our obstetrics team, partnered with Harvard Risk Management Strategies Foundation Team Performance Plus (TPP), implemented an initiative in May 2006. The primary goal of the initiative was to improve patient care through improved communication between disciplines, situation monitoring throughout the continuum of care, mutual support and respect among care givers, and effective team leadership. Through education and implementation of specific communication tools and behaviors, we realized better patient outcomes as well as improved patient and staff satisfaction.
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Successful management of obstetrical emergencies such as shoulder dystocia requires the coordinated efforts of a multidisciplinary team of professionals. Simulation education provides an opportunity to learn and master simple as well as complex technical skills needed in emergent situations. ⋯ In the healthcare environment, especially obstetrics where the stakes are high, integrating team training into simulation education can advance efforts to create and sustain a culture of safety. With over 7,100 deliveries annually, our 1,100-bed, two-hospital regional healthcare system embarked on this journey to advance the culture of safety.
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Creating work environments that sustain open and supportive communication positively influence teamwork, staff satisfaction, and improved patient quality and safety. The Situation, Background, Assessment, and Recommendation (SBAR)-collaborative communication evidence-based practice (EBP) study described in this article introduced collaborative communication integrating SBAR communication process in a pediatrics/perinatal services department of a 271-bed community hospital in northern Arizona. ⋯ Evaluation methods for intervention effectiveness and study outcomes integrated both quantitative and qualitative strategies. Staff transferred evidence, knowledge, and skills into practice to achieve enhanced communication, collaboration, satisfaction, and patient safety outcomes meeting the study goal.
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As the malpractice crisis in Obstetrics continues to spiral, safety initiatives within Obstetrics have grown to include simulation as a primary risk reduction strategy. Starting a simulation program requires careful planning and the commitment of all nursing and physician providers to promote a culture of patient safety. This article discusses eight recommended steps towards implementing a simulation program and illustrates through a case scenario how the process of building such a program will be integral to both its success and the fulfillment of your department's goals of providing excellent patient care.
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Case Reports Comparative Study
Successes and lessons learned implementing the sepsis bundle.
Sepsis is well described in the literature as a leading cause of possibly preventable death in the United States. Analysis of baseline data indicated capacity to reduce mortality, significant variation in clinical practice patterns and opportunities for reducing cost per case. Following an enterprise-wide challenge to save lives, a multidisciplinary, facility-based team was organized to improve sepsis care. Systematic improvements in recognizing sepsis and standardizing care resulted in a dramatic reduction in mortality and a significant reduction in direct variable cost.