Managing Obstetrical Risks
The Niagara Health System’s Maternal Child Program is advancing patient safety with an initiative called MORE OB. Managing Obstetrical Risks Effectively in Obstetrics is a multi-year program, held in collaboration with the Society of Obstetrics and Gynecology, focused on enhancing and promoting a culture of safety, quality care and professional development.
The health-care teams have been involved in various training modules, working on audits, emergency drills, skills drills, as well educational requirements to achieve the goals of the program. Some of the important principles in use are transferable to other disciplines.
Key principles of the program are:
- Safety is the priority and is everyone’s responsibility
- Operations are a team effort
- Communication is highly valued
- Hierarchy disappears in an emergency
- Emergencies are rehearsed
- There is a multidisciplinary review of routine processes, near misses and unexpected events
An estimated 100 obstetricians and gynecologists, family physicians, midwives and nurses in Niagara are actively participating in the MORE OB Program. In total, about 60 hospitals across Canada are participating in the project.
The project offers the NHS’s Maternal Child health-care teams an opportunity to review their labour and delivery practices and benchmark them against other hospitals. There are opportunities to share NHS best practice standards with other hospitals and also learn from their best practice initiatives. Study sessions, skills drills, emergency skills, mock scenarios including postpartum hemorrhage, monitoring fetal heart rates and twin deliveries are examples of the program.
There is a focus on the continued integration of the following patient safety initiatives;
- review and implementation of new fetal health surveillance guidelines
- latest research reviews and skilled training days on premature labour and ante-partum hemorrhage,
- further team building and communication training.
Fundamental to the MORE OB concept is a shift away from the traditional model of practice to a model in which all members of the health-care team work and learn together in what is called a community practice model. This new model breaks down traditional hierarchies and establishes an environment of teamwork, respect, trust, open communication and continuous learning among physicians, nurses and midwives.
The ultimate goals of the initiative are to enhance best practice initiatives and have standardized protocols in labour and delivery at our three hospital sites.