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.

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Creating a highly reliable perinatal service natividad medical center salinas ca

Creating a Highly ReliablePerinatal ServiceNatividad Medical CenterSalinas, 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
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


Formal briefings at designated times 0800 1130 1700 2300
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


Formal briefings at designated times

Provide meaningful background, stick to facts 2300

Talk about next steps

Encourage ongoing monitoring & cross-checking: it’s everyone’s responsibility to maintain situational awareness

Formal Briefings at Designated Times


Off going 2300

OB getting

ready for

board rounds

L&D RN

Oncoming OB

OR duty

Supervising

RN – L&D

OB in

clinic

Mother/Baby

Charge RN

Sleepy

resident

Charge RN – L&D


OB physician 2300

Family Medicine

physician

L&D RN


Oncoming 2300

OB

CRNA

On for 24 hrs

1styear

resident

Off going

OB



Five components to multidisciplinary rounds
Five Components to Multidisciplinary Rounds 2300

  • 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


Natividad s process
Natividad’s Process 2300

  • 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


Even the private physicians attend board rounds and report on their patients.

We are all on the same page


Labor and delivery charge rn

Keeps track of each member that attends board rounds on their patients.

Documents the category of each strip reviewed

Labor and Delivery Charge RN


Commitment
Commitment on their patients.

  • 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


Our champion – Dr Peter Chandler


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