Institution-Specific Perinatal Emergency Checklists: Multicenter Report on Development, Implementation, and...

Area of Science:

• Obstetrics and Gynecology
• Healthcare Quality Improvement
• Patient Safety

Background:

• Professional organizations recommend checklists to enhance obstetric care.
• Limited research exists on developing, implementing, and sustaining perinatal emergency checklists in clinical settings.
• This study addresses the need for evidence on creating and integrating these tools within diverse hospitals.

Purpose of the Study:

• To investigate the development and implementation processes of perinatal emergency checklists.
• To understand how these checklists are tailored and integrated into different hospital environments.
• To identify facilitators and barriers to the sustained use of perinatal emergency checklists.

Main Methods:

• A qualitative study involving clinicians from three diverse U.S. healthcare systems.
• Institution-tailored perinatal emergency checklists were developed and implemented.
• Interviews were conducted, and transcriptions were analyzed using the Consolidated Framework for Implementation Research.

Main Results:

• Checklists for 19 perinatal emergencies were created, with 10 topics common across all sites.
• Clinicians reported improved patient care during crises, reduced redundancy, and better coordination of obstetric emergencies.
• Checklist development occurred in small groups; implementation was facilitated by developers, with simulation deemed essential for refinement and team use.

Conclusions:

• Processes for developing, implementing, and sustaining perinatal emergency checklists were outlined.
• Multiple, parallel implementation strategies were key to creating a culture shift for checklist integration.
• The findings and framework can guide other institutions in adapting and sustaining perinatal emergency checklists.