Impact of simulation and team training on postpartum hemorrhage management in non-academic centers.

Objective: Prompt recognition and response to postpartum hemorrhage (PPH) are vital in preventing maternal morbidity and mortality. We conducted a multi-center study to evaluate in situ simulation and team training for PPH among experienced clinical teams in non-academic hospitals in urban and rural communities.

Methods: A longitudinal intervention study was performed in six Oregon community hospitals.

Relationship between fetal station and successful vaginal delivery in nulliparous women.

Objective: To study the relationship between fetal station and successful vaginal delivery in nulliparous women.

Study Design: This was a secondary analysis from a previously reported trial of pulse oximetry. Vaginal delivery rates were evaluated and compared with respect to the fetal station.

STORC safety initiative: a multicentre survey on preparedness & confidence in obstetric emergencies.

Background: Patient safety is a national and international priority. The purpose of this study was to understand clinicians' perceptions of teamwork during obstetric emergencies in clinical practice, to examine factors associated with confidence in responding to obstetric emergencies and to evaluate perceptions about the value of team training to improve preparedness.

Methods: An anonymous survey was administered to all clinical staff members who respond to obstetric emergencies in seven Oregon hospitals from June 2006 to August 2006.

Respiratory compliance in preterm infants after a single rescue course of antenatal steroids: a randomized controlled trial.

Objective: To compare respiratory compliance and functional residual capacity in infants randomized to a rescue course of antenatal steroids vs placebo.

Study Design: Randomized, double-blinded trial. Pregnant women > or =14 days after initial antenatal steroids were randomized to rescue antenatal steroids or placebo.

A new approach to postpartum rounds: patient-centered collaborative care improves efficiency.

Objective: At our institution, traditional postpartum rounds were time consuming and inefficient with a low percentage (approximately 12%) of patients meeting the goal of being discharged by 11:00 am. A patient-centered collaborative care (PCCC) initiative was implemented to improve discharge efficiency, staff communication, and patient satisfaction. We investigated whether this paradigm shift to PCCC could improve clinical inefficiencies and timely discharge.

Patient-centered collaborative care: the impact of a new approach to postpartum rounds on residents' perception of their work environment.

Objective: At our institution, traditional postpartum rounds consisted of separate visits from all members of the obstetric team. This led to patient care inefficiencies and miscommunication. In an effort to improve patient care, patient-centered collaborative care (PCCC) was established, whereby physicians, residents, medical students, nurses, case managers, and social workers conduct rounds as a team.

Teamwork in obstetric critical care.

Whether seeing a patient in the ambulatory clinic environment, performing a delivery or managing a critically ill patient, obstetric care is a team activity. Failures in teamwork and communication are among the leading causes of adverse obstetric events, accounting for over 70% of sentinel events according to the Joint Commission. Effective, efficient and safe care requires good teamwork.

Duration of antibiotic therapy after preterm premature rupture of fetal membranes.

Objective: This study was undertaken to compare the efficacy of 3 days versus 7 days of ampicillin in prolonging gestation for at least 7 days in women with preterm premature rupture of membranes (PPROM).

Study Design: We performed a randomized clinical trial comparing 3 days of ampicillin with 7 days ampicillin in patients with PPROM. Our primary outcome was the prolongation of pregnancy for at least 7 days.