OB STAT TEAM: Rapid Response Team for the Pregnant Patient

Purpose for the program: Approximately 1-2% of pregnancies are complicated by an obstetrical emergency. Effective rapid response to OB emergencies requires a multi-disciplinary approach. The OB Stat Team (OBST) was created at Aultman Hospital as a way to streamline rapid response to OB emergencies and to improve outcomes.

Proposed change: The Joint Commission for Accreditation of Healthcare Organizations has recommended that hospital teams review their policies regarding the availability of key personnel for emergency interventions. The implementation of rapid response teams is one strategy recommended by the Institute for Healthcare Improvement. The nationally accepted decision to incision time is 30 minutes for obstetrical emergencies requiring cesarean section delivery. The OBST was created to reduce that time and improve perinatal outcomes.

Implementation, outcomes and evaluation: We benchmarked other facilities and reviewed articles. We developed a policy and procedure and educated all disciplines: the hospital Communications Dept, OB residents and attending physicians, anesthesia, NICU, respiratory therapy, and nursing. Drills were conducted prior to live implementation to identify issues that needed corrected. Decision to incision time for emergencies requiring cesarean section delivery was reduced from 22 minutes in 2009 to 12 minutes in 2010. All calls are reviewed monthly by the multidisciplinary Perinatal Committee.

Implications for nursing practice: The OBST has been expanded to the adult intensive care units and the ED, so the OB nurses and team can get to the pregnant patient whereever she may be, when getting her to the Birth Center setting is unlikely or not appropriate.

Keywords: OB Stat Team, OB emergency response team, decision-to-incision time