creating a highly reliable perinatal service natividad medical center salinas, ca
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Creating a Highly Reliable Perinatal Service Natividad Medical Center Salinas, Ca. Multidisciplinary team at morning hand off. Communication- our quest is to be a team that has a shared understanding of what is going on. - PowerPoint PPT PresentationTRANSCRIPT
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Creating a Highly ReliablePerinatal Service
Natividad Medical CenterSalinas, Ca
Multidisciplinary teamat morning hand off
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Communication- our quest is to be a team that has a shared understanding of what is going on Communication is an essential component of
perinatal teamwork and has a significant impact on the risk of adverse outcomes
We use consistent and mutually agreed upon language to describe FHR patterns and to develop mutually expected interventions based on those patterns- NICHD terminology
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Formal Briefings at designated Times: 0800; 1130; 1700; 2300
Sets the tone for the day Discuss procedures, unexpected changes in the
care process Everyone knows the game plan, we are on the
same page Make sure the situation is owned by the entire
team The team includes oncoming and outgoing Family
Medicine and OB, residents, L&D RNs, The L&D Charge RN and the Mother/Baby Unit charge RN
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Formal Briefings at Designated Times
Provide meaningful background, stick to facts
Talk about next steps Encourage ongoing
monitoring & cross-checking: it’s everyone’s responsibility to maintain situational awareness
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Supervising RN – L&D
Charge RN – L&D
Oncoming OBOR duty
Mother/BabyCharge RN
L&D RN
Sleepyresident
Off going OB gettingready forboard rounds
OB inclinic
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Family Medicine physicianL&D RN
OB physician
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Oncoming OB
CRNAOn for 24 hrs1st year
resident
Off going OB
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“Let me tell you about last night!”
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Five Components to Multidisciplinary Rounds
Timely briefings: 0800; 1100; 1700; 2300 Courtesy Review labor curve Clear Communication:
SBAR “I need clarity” – used to stop an event or clarify
plan of care Consistent use of NICHD terminology when
reviewing FHR during board rounds
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Natividad’s Process
All team members gather on time Each patient’s case is discussed, the FHR
monitor strip is reviewed using NICHD terminology
Be brief, complete, RN shares current information with team
Even the private physicians present their patients as part of the team and review the fetal monitor strip
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Even the private physicians attend board rounds and report on their patients.We are all on the same page
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Labor and Delivery Charge RN
Keeps track of each member that attends board rounds
Documents the category of each strip reviewed
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Commitment
The entire team is committed to being a part of the communication process
Efficient situational awareness is owned and practiced by the entire perinatal team
On-going updates, cross-talk, cross-checks, verifying that the entire team knows what is happening
The entire team knows what should happen next
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Our champion – Dr Peter Chandler