Laurie Owens RNC, BSN

August 18, 2008

Abstract            Auburn Regional Medical Center in Auburn Washington, a UHS hospital, has developed guidelines for a High Reliability OB Unit under a directive from corporate headquarters. UHS saw a need to advance patient safety and satisfaction in all UHS hospital OB units. Auburn Regional Medical Center continues to develop and improve guidelines by a Multi-Disciplinary task force. The Multi-Disciplinary Committee, integrating the principles of high reliability organizations, and team function, is focused on a culture of sustained patient safety, continuous improvement in quality of care, and observed reductions in negative outcome events. The Multi-Disciplinary Committee operates on the principle that patient safety is everyone's responsibility, and so has encouraged the unit to develop or utilize tools to accomplish this goal.            Among the tools currently used by Auburn Regional Medical Center are:

¨      Communication devices that allow instant communication with physicians, nurses, and ancillary services.

¨      Fetal Monitoring Strip of the Month. Fetal monitor strip review and quiz by an AWHONN certified fetal monitoring instructor.

¨      Monthly article review. Employees will choose an article describing evidence-based practice. Discussion takes place and possible submission to the Multi-Disciplinary Committee.

¨      Monthly mock emergency codes in areas of high risk such as prolapsed cord, maternal hemorrhage, OR fires, and shoulder dystocia. Mock codes have shown a reduction in negative outcome events and an improvement in efficiency of the team.

¨      Multi disciplinary committee. This committee is made up of volunteers from the disciplines of Medicine, Nursing, Anesthesia, and Ancillary Services. The committee develops and revises policy and procedure, develops guidelines for department, physician, and ancillary service education using ACOG and AWHONN guidelines, as well as researching evidence-based practices for best practice.

¨      Remote fetal surveillance access for physicians.

¨      SBAR patient hand-off report and kardex forms for uniformity and consistency in nurse-to-nurse, nurse to physician, and department-to-department patient status reporting.

¨      Tracking and auditing tools. Continuous chart audits. Implementation of 8 hour chart audits for self evaluation. Patient satisfaction surveys. Call light monitoring tool.            Tools in development for future use by Auburn Regional Medical Center are as follows:

¨      Improved fetal surveillance and charting program.

¨      Other tools are currently being considered by the committee.            Ensuring consistency and quality of care, and patient safety is vital to the Family Birth Center at Auburn Regional Medical Center. Communication, workflow efficiency and effectiveness, training and education, and consistency across the unit are paramount to the team at Auburn, and having the tools available is an important aspect of the High Reliability Unit.