Using Emergency Obstetric Drills in Maternity Units as a Performance Improvement Tool

Abstract

Background: Obstetric drills are being used increasingly to test, improve, and maintain knowledge and skills related to obstetric emergencies as a means to improve proficiency and efficiency of practitioners. The purpose of this study was to assess the feasibility and usefulness of conducting drills to evaluate the response to obstetric emergencies using a holistic approach that tested the hospital system. Methods: A prospective trial was conducted at three hospitals (two tertiary referral centers and one small community hospital) in Beirut, Lebanon. Two different emergency obstetric drills at two points in time were conducted between April and May 2006 either in the emergency room or on the labor floor. The drills included medical and paramedical staff, a female actor (simulating a pregnant woman), a research assistant (acting as her companion), and a physician trained in obstetrics (the drill leader). Responses were recorded and critically analyzed. Results: Although overall quality of care was within standards of care, problems were identified related to hospital policies, supplies and equipment, communication, and clinical management. Some technical problems related to administration of the drills were identified. Most drill participants appreciated the exercise and found it beneficial. Conclusions: Obstetric drills provide a useful tool to identify and address deficiencies in the hospital system. This finding could have implications on improving quality of care provided to obstetric patients. (BIRTH 36

Delivering interventions to reduce the global burden of stillbirths: improving service supply and community demand

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Advanced Life Support in Obstetrics (ALSO) and post-partum hemorrhage: a prospective intervention study in Tanzania

“…Drills are ‘ in situ simulations’ of obstetric emergencies performed in a realistic scenario, often during work and using actors instead of mannequins (23). A qualitative study from Lebanon suggested that antepartum hemorrhage and eclampsia drills improved staff response when the same drills were repeated some months later (24). Other EmOC courses similar to ALSO, for example the RCOG's Life Saving Skills in Obstetrics (25), use mannequins to cover a number of obstetric and neonatal complications.…”

Peripartum interventions resulting in reduced perinatal mortality rates, and birth asphyxia rates, over 18 years in a tertiary centre in South India: a retrospective study

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“…Similar models have been used as performance improvement tools. 16 Training in reading and interpreting cardiotocographs was also done and emphasis was placed on using correct terminology. This enabled faster recognition of abnormal traces, better communication, and accurate documentation.…”