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Confronting safety gaps across labor and delivery teams

David G Maxfield1, Audrey Lyndon, Holly Powell Kennedy

  • 1Department of Research, VitalSmarts LC, Provo, UT.

American Journal of Obstetrics and Gynecology
|July 23, 2013
PubMed

We assessed the occurrence of 4 safety concerns among labor and delivery teams: dangerous shortcuts, missing competencies, disrespect, and performance problems. A total of 3282 participants completed surveys, and 92% of physicians (906 of 985), 93% of midwives (385 of 414), and 98% of nurses (1846 of 1884) observed at least 1 concern within the preceding year. A majority of respondents said these concerns undermined patient safety, harmed patients, or led them to seriously consider transferring or leaving their positions. Only 9% of physicians, 13% of midwives, and 13% of nurses shared their full concerns with the person involved. Organizational silence is evident within labor-and-delivery teams. Improvement will require multiple strategies, used at the personal, social, and structural levels.

Keywords:
communicationorganizational silencepatient safetypsychological safety

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