Childbirth teams at Indian Path Medical Center improve communication with simulation training


KINGSPORT, Tenn. – A woman in labor lies on an operating table. The delivery of her child has not gone as she expected, and she is now in the midst of an emergency Cesarean section. 

The doctors and nurses caring for her know exactly what she needs, but getting all the right pieces together at the right time is difficult in the tense environment of an obstetrics emergency, when every second counts.

To help make sure that OB teams work together swiftly and seamlessly, Indian Path Medical Center (IPMC) has begun a new simulation training program that tests and refines the communication and teamwork skills of its clinical professionals. 

The simulation training is part of a program called Team STEPPS (for Strategies and Tools to Enhance Performance and Patient Safety). Team STEPPS is a product of the Agency for Healthcare Research and Quality (AHRQ), a division of the U.S. Department of Health and Human Services. 

“This is something that we’re doing for perinatal safety that nobody else in the region is doing right now,” said Cathy Ivory, corporate director of women’s services for Mountain States Health Alliance (MSHA). “More than 70 percent of adverse events in labor and delivery are related to breakdowns in communication. The problem is not the skill level or availability of the provider.” 

Using actors who pose as patients and family, IPMC clinical team members simulate some of the most common obstetrics emergencies. The exercise is filmed, and team members gather afterward to watch the video and evaluate how well they communicated. 

Because they are accustomed to handling OB emergencies from a clinical standpoint, team members often don’t realize the ways their communication skills can improve until they watch the video. “In one of our drills, the doctor asked for a medication, and two people went to get it because nobody knew who he gave that direction to. And because neither of them responded, he didn’t know for sure that the medication was coming at all,” Ivory said. 

The goal of Team STEPPS is to streamline communication during emergencies so that every second can be used efficiently. 

IPMC’s participation in Team STEPPS is funded by a national AHRQ grant that was awarded to Premier, Fairview Health System and the University of Minnesota. The Family Birth Center at IPMC is one of 14 teams in the nation participating in this three-year project.

The group’s next simulation exercise is scheduled for April 6 at noon. Media is invited to join MSHA team members for the debriefing following the exercise and view video of the simulation training. For more information, call Teresa Hicks at 423-431-1313
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