Confronting safety gaps across labor and delivery teams

Area of Science:

• Healthcare quality and safety
• Obstetrics and Gynecology
• Medical team dynamics

Background:

• Patient safety in labor and delivery is paramount.
• Concerns regarding professional conduct and performance can impact care quality.
• Understanding team dynamics is crucial for improving safety outcomes.

Purpose of the Study:

• To assess the prevalence of specific safety concerns within labor and delivery teams.
• To evaluate the impact of these concerns on patient safety and healthcare professionals.
• To identify barriers to reporting such issues within these teams.

Main Methods:

• A survey was administered to labor and delivery team members, including physicians, midwives, and nurses.
• Data collected included the occurrence of dangerous shortcuts, missing competencies, disrespect, and performance problems.
• Participant responses on the impact of concerns and reporting behaviors were analyzed.

Main Results:

• A high percentage of physicians (92%), midwives (93%), and nurses (98%) reported observing at least one safety concern in the past year.
• A majority of respondents indicated that these concerns negatively affected patient safety, caused patient harm, or led to thoughts of leaving their jobs.
• Reporting rates were low, with only 9% of physicians, 13% of midwives, and 13% of nurses fully disclosing their concerns to the individual involved.

Conclusions:

• Significant organizational silence exists within labor and delivery teams regarding safety concerns.
• Addressing these issues requires a multifaceted approach targeting personal, social, and structural levels.
• Interventions should focus on promoting open communication and psychological safety to improve the reporting of concerns.