Start/Search | Browse by Day | Author Index

Clear communication among the care providers in the L&D setting has always been a concern in providing a safe environment for the patient.  Developing a team training program to enhance patient safety, lead to an epiphany: team training innovations increased nurse satisfaction as evidenced by annual NDNQI Survey Scores.

150 members of the team: nurses, physicians, nursing support technicians, unit secretaries, and residents were involved in the training process.  The leadership of the unit, Chairman of OB/GYN, Director of Maternal Child Health, Manager of Labor & Delivery, Manager of Mother/Baby and Clinical Nurse Specialist, collaborated to become the role models for change. Each member of the leadership team taught multidisciplinary groups, allowing for a wide spectrum of opinions and lively discussions.  These interactions between the different roles helped to establish a renewed rapport that translated into an environment of mutual support and respect.

After six weeks of four hour sessions, go-live began with the establishment of several team solutions: briefs, huddles and debriefs.  The brief was a 15 minute interchange of the patients’ clinical status, initiated by a clearly, defined, team leader (charge nurse).  Briefs were attended by all members of the team, with each member contributing and discussing the plan of care for the patient. Team goals were established during the brief. Barriers to achieving the goals were discussed and solutions implemented.  An objective observer monitored and scored the group activity during the Brief.

Huddles were introduced when there was a change of status or plan that required updating of the team.  Huddles are an opportunity for team members to gather new information and adapt appropriately. 

Critical events occur in every setting.  Debriefs are a form of quality improvement that allow team members to evaluate their performance after a critical situation. In an atmosphere of safety and honesty, the group view errors as learning opportunities, and develop strategies and solutions.

With a renewed sense of collaboration, empowerment to question the physicians, and support of their peers, the Nursing Staff demonstrated increased self esteem and worth as depicted through the NDNQI Nurse Survey Scores.  This annual survey showed an increase in Job Enjoyment from moderate satisfaction to high satisfaction.