Multi-organization call to action identifies and addresses safety concerns in labor

A healthcare, industry-first collaborative blueprint for labor and delivery safety, developed by four leading professional organizations in maternal health, calls for improving communication among clinicians, team leaders, administrators, health care providers, organizations, and patients to ensure fewer risks and better outcomes for mothers and babies.

The four collaborating organizations are the American College of Nurse-Midwives; the American College of Obstetricians and Gynecologists; the Association of Women's Health, Obstetric and Neonatal Nurses; and the Society for Maternal-Fetal Medicine. Additionally, these organizations partnered with VitalSmarts, a research and training organization.

The report, "Transforming Communication and Safety Culture in Intrapartum Care: A Multi-organization Blueprint," follows previous research on safety concerns during childbirth and communication among labor and delivery teams. The report appears in the April 7 edition of the Journal of Obstetric, Gynecologic, & Neonatal Nursing and will also appear in the Journal of Midwifery & Women's Health and Obstetrics & Gynecology (The Green Journal).

As a call to action, the Blueprint outlines ways in which individual clinicians, team leaders, administrators, health care providers, organizations and associations, and even patients can use enhanced communication to improve outcomes in labor and delivery.

"The research shows that a lack of speaking up and proper dialogue is a significant problem when it comes to risks during labor and childbirth," said David Maxfield, vice president of research at VitalSmarts and lead researcher on one of the studies and the resulting Blueprint. VitalSmarts, which assisted with the Blueprint, consults with the organizations on the development of training and resources to improve cultures of silence in perinatal care. "Proper communication is essential for labor and delivery teams to respond to rapidly changing and life-threatening events that can occur during the birthing process."

This communication is fundamental to the safety of mothers and babies. The Blueprint points out that the inability of a clinical team to speak up or effectively communicate can have a devastating impact.

Studies suggest that at least 50 percent of maternal morbidity and mortality is in some way preventable. Several organizations have demonstrated that implementation of safety programs are scalable and can be one powerful way to improve safety and patient outcomes.

The Blueprint states, "It takes an expert team and mutual accountability to provide excellent care to women and families. Differences of opinion about clinical assessments, goals of care, and the pathway to optimal outcomes are bound to occur with some regularity in the dynamic environment of labor and delivery. Every person has the responsibility to contribute to improving how we relate to and communicate with each other.

"Collectively we must create environments in which every team member (patient, physician, midwife, nurse, unit clerk, patient care assistant, scrub tech, etc.) is comfortable expressing and discussing their concerns about safety and performance, and is encouraged to do so, and has the support of the team to articulate their rationale for and urgency of their concern without fear of put-downs, retribution, or receiving poor quality care."