How We Got Smart

Abstract

Communication around high-risk deliveries is critical to ensure patient safety. A hospital-wide system change in paging the neonatal resuscitation team (NRT) to deliveries was implemented but disliked. An interdisciplinary team seized the opportunity to explore opportunities for an enhanced system to improve communication. The team designed a new screen to our smart panel (responder 5 staff terminal, Rauland, Mount Prospect, Illinois) to page NRT with the location and primary indication for which they were needed at delivery. Surveys assessed user satisfaction among labor and delivery and NRT. Before and after implementation of the smart panel, we assessed number of NRT pages, frequency of NRT being paged prior to the delivery, the time between page and delivery, and use of the code button to summon help. Labor and delivery and NRT user satisfaction greatly improved with the smart panel. Frequency of NRT being paged before birth increased with fewer code pages being used to summon NRT to deliveries. A touch screen-based notification system can enhance timely notification to summon NRT to deliveries while concurrently enhancing satisfaction of providers in both the delivery room and on the NRT.

Ergonomic Challenges Inherent in Neonatal Resuscitation

“…The call for the neonatal resuscitation team is an opportunity to relay key information that is vital to ensuring that the team has the right information at the right time and is adequately prepared to resuscitate and stabilize the newborn infant [41,42]. However, there can be significant practice variation between and even within centers regarding how the neonatal resuscitation team is activated.…”

“…This was demonstrated by the same authors following a change in the communication system used to summon the neonatal resuscitation team; the implementation of a call center responsible for paging all emergency response teams in the entire hospital resulted in significant and unexpected negative effects. Mandating that phone calls to summon the neonatal resuscitation team be routed through this call center led to a substantial increase in the inappropriate use of a code button by labor and delivery staff, who preferred to circumvent the call center altogether [42]. Communicating with the call center staff was seen as less timely and more cumbersome than previous methods of summoning the neonatal resuscitation team and the swift response that could be obtained by pressing the code button.…”