Situational awareness and its application in the delivery suite

The delivery suite is a high-risk environment. Transitions between low-risk and high-risk can be swift, and sentinel events can occur without warning. The prevention of accidents in this environment rests on the vigilance of the individual practitioner at the frontline. It is, therefore, important that the individual practitioner should develop and maintain the cognitive skills to anticipate, recognize, and intercept unfolding error chains. This commentary gives an overview of a nontechnical skill that is essential for safe practice in a delivery suite: situational awareness. A basic description of situational awareness is provided, using examples of loss of situational awareness in the delivery suite and examples of simple interventions that could promote situational awareness. Involuntary automaticity readily creeps in during performance of routine tasks, and cognitive overload could deplete attentional resources that are, by nature, limited. Strategies and tactics for maintaining situational awareness include proactively seeking and managing information on unfolding events, continually updating individual and team mental models, mindful use of checklists and scoreboards, and avoidance of attentional blindness. These simple interventions require minimal financial resources but could immensely enhance clinical performance and patient safety. Situational awareness should be included in the training of obstetrician-gynecologists and other staff working in a delivery suite.