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Development and implementation of a team-centered shoulder dystocia protocol.

William A Grobman1, Abby Hornbogen, Carol Burke

  • 1Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA. w-grobman@northwestern.edu

Simulation in Healthcare : Journal of the Society for Simulation in Healthcare
|February 19, 2011
PubMed
Summary

Developing a team-centered shoulder dystocia protocol using simulations improved obstetric team function. Low-fidelity drills effectively introduced and enhanced teamwork for managing shoulder dystocia emergencies.

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Area of Science:

  • Obstetrics and Gynecology
  • Medical Education
  • Patient Safety

Background:

  • Shoulder dystocia is a critical obstetric emergency requiring coordinated team response.
  • Existing management protocols may not adequately address team dynamics and communication.
  • Identifying and mitigating impediments to optimal team function is crucial for improving patient outcomes.

Purpose of the Study:

  • To develop and evaluate a team-centered protocol for managing shoulder dystocia.
  • To identify and address common challenges faced by obstetric teams during shoulder dystocia events.
  • To enhance provider performance and teamwork through simulation-based training.

Main Methods:

  • A two-phase approach involving protocol development and dissemination.
  • Phase 1: Protocol creation through provider interviews and iterative refinement.
  • Phase 2: Dissemination via low-fidelity simulation with quantitative analysis of protocol component adherence.

Main Results:

  • Qualitative analysis identified impediments: delayed recognition, communication issues, unclear roles, and documentation variability.
  • A developed protocol effectively addressed these impediments.
  • Simulated drills demonstrated increased incorporation of protocol actions by providers over time.

Conclusions:

  • Low-fidelity simulation is an effective method for introducing and improving teamwork in shoulder dystocia management.
  • Team-centered protocols can enhance the coordinated response to shoulder dystocia.
  • Simulation-based training is valuable for optimizing obstetric emergency preparedness.