Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study

Abstract Background Progress in medicine involves the structured analysis and communication of errors. Comparability between the individual disciplines is only possible to a limited extent and obstetrics plays a special role: the expectation of a self-determined and joyful event meets with possibly...

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Main Authors: Beate Hüner, Christina Derksen, Martina Schmiedhofer, Sonia Lippke, Sandra Riedmüller, Wolfgang Janni, Frank Reister, Christoph Scholz
Format: Article
Language:English
Published: BMC 2023-01-01
Series:BMC Pregnancy and Childbirth
Subjects:
Online Access:https://doi.org/10.1186/s12884-022-05304-8
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author Beate Hüner
Christina Derksen
Martina Schmiedhofer
Sonia Lippke
Sandra Riedmüller
Wolfgang Janni
Frank Reister
Christoph Scholz
author_facet Beate Hüner
Christina Derksen
Martina Schmiedhofer
Sonia Lippke
Sandra Riedmüller
Wolfgang Janni
Frank Reister
Christoph Scholz
author_sort Beate Hüner
collection DOAJ
description Abstract Background Progress in medicine involves the structured analysis and communication of errors. Comparability between the individual disciplines is only possible to a limited extent and obstetrics plays a special role: the expectation of a self-determined and joyful event meets with possibly serious complications in highly complex care situations. This must be managed by an interdisciplinary team with an increasingly condensed workload. Adverse events cannot be completely controlled. However, taking controllable risk factors into account and with a focused communication a reduction of preventable adverse events is possible. In the present study, the effect of interprofessional team training on preventable adverse events in an obstetric department was investigated. Methods The training consisted of a 4-h interdisciplinary training session based on psychological theories. Preventable adverse events were defined in six categories according to potential patterns of causation. 2,865 case records of a refence year (2018) and 2,846 case records of the year after the intervention (2020) were retrospectively evaluated. To determine the communication training effect, the identified preventable adverse events of 2018 and 2020 were compared according to categories and analyzed for obstetrically relevant controllable and uncontrollable risk factors. Questionnaires were used to identify improvements in self-reported perceptions and behaviors. Results The results show that preventable adverse events in obstetrics were significantly reduced after the intervention compared to the reference year before the intervention (13.35% in the year 2018 vs. 8.83% in 2020, p < 0.005). Moreover, obstetrically controllable risk factors show a significant reduction in the year after the communication training. The questionnaires revealed an increase in perceived patient safety (t(28) = 4.09, p < .001), perceived communication behavior (t(30) = -2.95, p = .006), and self-efficacy to cope with difficult situations (t(28) = -2.64, p = .013). Conclusions This study shows that the communication training was able to reduce preventable adverse events and thus increase patient safety. In the future, regular trainings should be implemented alongside medical emergency trainings in obstetrics to improve patient safety. Additionally, this leads to the strengthening of human factors and ultimately also to the prevention of second victims. Further research should follow up implementing active control groups and a randomized-controlled trail study design. Trial registration The study was approved by the Ethics Committee of University Hospital  (protocol code 114/19-FSt/Sta, date of approval 29 May 2019), study registration: NCT03855735 .
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spelling doaj.art-1370a935d426470d86d637d863e710ae2023-01-29T12:24:08ZengBMCBMC Pregnancy and Childbirth1471-23932023-01-0123111310.1186/s12884-022-05304-8Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention studyBeate Hüner0Christina Derksen1Martina Schmiedhofer2Sonia Lippke3Sandra Riedmüller4Wolfgang Janni5Frank Reister6Christoph Scholz7University Hospital Ulm, Department of Gynecology and ObstetricsJacobs University Bremen, Department of Psychology & MethodsJacobs University Bremen, Department of Psychology & MethodsJacobs University Bremen, Department of Psychology & MethodsUniversity Hospital Ulm, Department of Gynecology and ObstetricsUniversity Hospital Ulm, Department of Gynecology and ObstetricsUniversity Hospital Ulm, Department of Gynecology and ObstetricsMuenchen Klinik, Department of Gynecology and ObstetricsAbstract Background Progress in medicine involves the structured analysis and communication of errors. Comparability between the individual disciplines is only possible to a limited extent and obstetrics plays a special role: the expectation of a self-determined and joyful event meets with possibly serious complications in highly complex care situations. This must be managed by an interdisciplinary team with an increasingly condensed workload. Adverse events cannot be completely controlled. However, taking controllable risk factors into account and with a focused communication a reduction of preventable adverse events is possible. In the present study, the effect of interprofessional team training on preventable adverse events in an obstetric department was investigated. Methods The training consisted of a 4-h interdisciplinary training session based on psychological theories. Preventable adverse events were defined in six categories according to potential patterns of causation. 2,865 case records of a refence year (2018) and 2,846 case records of the year after the intervention (2020) were retrospectively evaluated. To determine the communication training effect, the identified preventable adverse events of 2018 and 2020 were compared according to categories and analyzed for obstetrically relevant controllable and uncontrollable risk factors. Questionnaires were used to identify improvements in self-reported perceptions and behaviors. Results The results show that preventable adverse events in obstetrics were significantly reduced after the intervention compared to the reference year before the intervention (13.35% in the year 2018 vs. 8.83% in 2020, p < 0.005). Moreover, obstetrically controllable risk factors show a significant reduction in the year after the communication training. The questionnaires revealed an increase in perceived patient safety (t(28) = 4.09, p < .001), perceived communication behavior (t(30) = -2.95, p = .006), and self-efficacy to cope with difficult situations (t(28) = -2.64, p = .013). Conclusions This study shows that the communication training was able to reduce preventable adverse events and thus increase patient safety. In the future, regular trainings should be implemented alongside medical emergency trainings in obstetrics to improve patient safety. Additionally, this leads to the strengthening of human factors and ultimately also to the prevention of second victims. Further research should follow up implementing active control groups and a randomized-controlled trail study design. Trial registration The study was approved by the Ethics Committee of University Hospital  (protocol code 114/19-FSt/Sta, date of approval 29 May 2019), study registration: NCT03855735 .https://doi.org/10.1186/s12884-022-05304-8Adverse eventsPreventable adverse eventsObstetricsCommunicationPatient safety
spellingShingle Beate Hüner
Christina Derksen
Martina Schmiedhofer
Sonia Lippke
Sandra Riedmüller
Wolfgang Janni
Frank Reister
Christoph Scholz
Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study
BMC Pregnancy and Childbirth
Adverse events
Preventable adverse events
Obstetrics
Communication
Patient safety
title Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study
title_full Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study
title_fullStr Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study
title_full_unstemmed Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study
title_short Reducing preventable adverse events in obstetrics by improving interprofessional communication skills – Results of an intervention study
title_sort reducing preventable adverse events in obstetrics by improving interprofessional communication skills results of an intervention study
topic Adverse events
Preventable adverse events
Obstetrics
Communication
Patient safety
url https://doi.org/10.1186/s12884-022-05304-8
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