Safe Surgery Education: Improving Patient Care on Labor and Delivery Units
ACOG ePoster. Chen J. Apr 27, 2018; 211461; 17O
Joseph Chen
Joseph Chen
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Abstract
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Introduction: In 1999, the U.S. Institute of Medicine launched a movement in healthcare to improve patient care and to decrease medical errors on a national level. These initiatives sparked dramatic changes to improve provider hand-off processes, decrease preventable errors and adverse outcomes. Similarly, observational obstetrical studies have shown that maternal morbidity and mortality can be decreased through checklists and safety steps. At our institution, we introduced Obstetrical Safe Surgery Education Program to further decrease medical errors in vaginal (VD) and cesarean deliveries (CD). This prospective study evaluated objective differences in patient care using standardized audit tools before and after program introduction at a single institution.

Methods: Baseline delivery audits of OBGYN physicians, nursing and anesthesia providers were performed using an institutionally-standardized checklist (VD-20 items, CD-62 items) by trained observers from January 2015-May 2016. Education of staff and physicians was provided using visual aids, formal training courses, lectures and mock drills. Following this,128 VD and CD were randomly audited. Objective measures included accuracy of instrument counts, effective communication between staff and adequate documentation of care. Scores were calculated based on total percentage of correctly performed items.

Results: Prior to the education introduction, the average percentage of correctly performed items in VD and CD were 69% and 88%, respectively. Following the educational period, the average percentages respectively increased to 81% (P=0.29), 91% (P=0.94). Improvements were observed in all objective measures.

Conclusion/Implications: A multimodal approach of healthcare education can lead to clinical improvements in patient care. Larger studies are required to delineate barriers of education implementation.
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