Implementation of an Obstetrical Rapid Response Team
Heale, Patricia A.
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(41st Biennial Convention) Over the last decade there has been a significant increase in the maternal mortality rate from 6.6 deaths per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006. Following a series of near misses the hospital initiated an investigation into the management of obstetrical emergencies. The OBRRT concept was to bring additional care providers to the bedside prior to a true emergency. The concept was presented at multi-disciplinary meetings, at various levels throughout the organization and was inclusive of all stakeholders who were instrumental in reviewing systems and processes. The goals for establishing an OB RRT were: to empower each staff member to activate the OB RRT; to bring a multidisciplinary group of expert healthcare providers to the bedside in the case of deteriorating maternal/fetal status and improve maternal and neonatal outcomes. The multidisciplinary Planning Committee established the clinical criteria of a crisis and determined the appropriate response team members and roles of the team. Practice drills were performed and debriefing sessions were held to discuss positive and negative challenges encountered during the activation. Within one week of implementation the OBRRT was activated three times with excellent patient outcomes and a high degree of staff satisfaction. Many avenues were utilized to ensure successful education including online education, in-services and low and high fidelity simulation. Every activation or non-activation of the OBRRT is reviewed by the Planning Committee and reported to the Obstetric/Gynecologic Service Committee. Each activation is evaluated for the accuracy of the group page, team's response time, the reason for the activation, interventions made and patient outcome. In conclusion, the use of multidisciplinary planning teams, teamwork, thorough planning and ongoing evaluation can lay the foundation for a successful OB RRT.