How can communication errors be prevented in obstetrics?

From the Guidelines

Communication errors in obstetrics can be prevented through improving communication within care teams, implementing evidence-based bundles and protocols, and decreasing variation in care in all facilities providing obstetrical services. To achieve this, healthcare providers should focus on strategies such as structured handoffs, standardized communication protocols, and team training 1. Implementing tools like SBAR (Situation, Background, Assessment, Recommendation) for clear information exchange and using checklists during critical events such as deliveries and emergencies can also help prevent communication errors.

Key Strategies for Prevention

• Regular interdisciplinary team simulations to practice communication during high-stress situations
• Optimizing electronic health records with clear documentation standards and alert systems for critical information
• Establishing a culture of psychological safety where all team members feel comfortable speaking up about concerns
• Briefings before procedures, debriefings afterward, and closed-loop communication to reduce misunderstandings
• Patient involvement through clear explanations of care plans and encouraging questions to prevent errors
• Having interpreters available for non-English speakers to ensure effective communication

According to the Society for Maternal-Fetal Medicine Consult Series #54, assessing the risk of maternal morbidity and mortality is crucial, and communication failures are a significant contributor to preventable maternal mortality 1. Therefore, prioritizing communication and implementing strategies to improve it is essential for reducing maternal morbidity and mortality. By acknowledging and combating implicit bias and structural racism at the provider and healthcare system levels, healthcare providers can further reduce maternal morbidity and mortality 1.

Addressing Systemic Issues

• Decreasing variation in care among facilities
• Implementing evidence-based bundles and protocols
• Eliminating “care deserts” through telemedicine and innovative referral networks
• Improving access to the full range of reproductive health services, including contraception and abortion
• Providing effective patient education resources on signs and symptoms of common complications and strategies for minimizing risk

By addressing these systemic issues and implementing strategies to improve communication, healthcare providers can significantly reduce communication errors in obstetrics and improve patient outcomes.

From the Research

Strategies to Prevent Communication Errors in Obstetrics

To prevent communication errors in obstetrics, several strategies can be employed:

• Implementing mandatory interprofessional meetings, acceptance of subjective mistakes, mutual understanding, and debriefings of conflict situations can improve collaboration among healthcare workers 2
• Conducting emergency trainings, trainings in precise communication, and handovers can reduce risks for preventable adverse events (pAEs) 2
• Using a safe surgery checklist, such as the World Health Organization Safe Surgery Checklist, can improve communication among team members and reduce documentation discrepancies 3
• Providing opportunities for simulation-based training to identify and address common lapses in verbal communication can foster efficient communication in labor and delivery units 4
• Implementing communication interventions, such as the P.U.R.E. (Purposeful, Unambiguous, Respectful, and Effective) process, can improve care-coordination for high-risk births 5

Benefits of Communication Interventions

Communication interventions in obstetrics have been shown to have a positive effect on proximal outcomes, such as communication skills, and can also improve distal performance indicators, such as patient safety 6

• These interventions can be applied to improve communication among staff, students, and pregnant women and their partners, ultimately enhancing patient safety 6
• However, the evidence level of studies on communication interventions in obstetrics is generally low, highlighting the need for more high-quality research in this area 6

Common Barriers to Effective Communication

Common barriers to effective communication in obstetrics include:

• Time-constraints and understaffing, which can hinder safe communication among healthcare workers 2
• Inefficient verbal communication, which can lead to repeated questions and delays in patient care 4
• Lack of standardization in communication protocols, which can contribute to errors and adverse patient outcomes 3