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Interventions for improving teamwork in intrapartem care: a systematic review of randomised controlled trials.
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- Author(s): Wu, Michael; Tang, Jennifer; Etherington, Nicole; Walker, Mark; Boet, Sylvain
- Source:
BMJ Quality & Safety; Jan2020, Vol. 29 Issue 1, p77-85, 9p, 2 Diagrams, 3 Charts- Subject Terms:
ATTITUDE (Psychology); CINAHL database; CLINICAL competence; DECISION support systems; HEALTH care teams; MEDICAL databases; INFORMATION storage & retrieval systems; MEDICAL information storage & retrieval systems; INTERPROFESSIONAL relations; EVALUATION of medical care; MEDICAL personnel; MEDLINE; OBSTETRICS; QUALITY assurance; RESEARCH funding; TEAMS in the workplace; SYSTEMATIC reviews; COMORBIDITY; JOB performance; ADVERSE health care events; INTRAPARTUM care; EVALUATION; EQUIPMENT & supplies - Source:
- Additional Information
- Subject Terms:
- Abstract: Background The labour and delivery environment relies heavily on interdisciplinary collaboration from anaesthesiologists, obstetricians and nurses or midwives to deliver optimal patient care. A large number of adverse events in obstetrics are associated with failure in communication and teamwork among team members, with substantive consequences. The objective of this study is to perform a systematic review of interventions aimed at improving teamwork in obstetrics. Methods This systematic review identified and assessed randomised controlled trials (RCTs) of interventions aimed at improving teamwork among interdisciplinary teams in obstetrical care. Medline, CENTRAL, CINAHL and Embase were searched for studies evaluating one of: patient outcomes, team performance or processes of clinical efficiency. Identified citations were reviewed in duplicate for eligibility. Results Nine RCTs met the inclusion criteria; five of these RCTs were conducted under simulated clinical environments. Simulation-based teamwork training interventions were the most represented (n=7 studies, 3047 healthcare providers (HCPs), 107 782 births), followed by checklists (n=1 study, 136 HCPs) and an electronic-based decision support tool (n=1 study, 296 HCPs). Simulation-based teamwork training was found to improve team performance in 100% of relevant studies (3 of 3 studies assessing team performance) and patient morbidity in 75% of relevant studies (3 of 4 studies assessing patient morbidity). However, no direct mortality benefit was identified among all the studies reviewed. Studies were assessed to be of low-moderate quality and had significant limitations in their study designs. Conclusion While the evidence is still limited and from low to moderate quality RCTs, simulation-based teamwork interventions appear to improve team performance and patient morbidity in labour and delivery care. PROSPERO Trial registration number: CRD42018090452. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of BMJ Quality & Safety is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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