Checklists and multidisciplinary team performance during simulated obstetric hemorrhage. (February 2016)

• Record Type: Journal Article
• Authors: Hilton, G.; Daniels, K.; Goldhaber-Fiebert, S.N.; Lipman, S.; Carvalho, B.; Butwick, A.
• Is Part Of: International journal of obstetric anesthesia. Volume 25(2016)
• Page Start: 9
• Page End: 16
• Publication Date: 2016-02
• Subjects: Checklist -- Multidisciplinary -- Obstetrics -- Postpartum hemorrhage -- Simulation; Obstetrics -- Periodicals; Anesthesia -- Periodicals; Anesthésie en obstétrique -- Périodiques; Anesthesia; Obstetrics; Electronic journals; Periodicals; 617.9682
• DOI: 10.1016/j.ijoa.2015.08.011
• Languages: English
• ISSNs: 0959-289X

Abstract

Highlights: This study evaluated checklist use and team performance during simulated postpartum hemorrhage. Checklist training was effective in promoting a high rate of checklist use. There is noticeable variability in how people use checklists. Abstract: Background: Checklists can optimize team performance during medical crises. However, there has been limited examination of checklist use during obstetric crises. In this simulation study we exposed multidisciplinary teams to checklist training to evaluate checklist use and team performance during a severe postpartum hemorrhage. Methods: Fourteen multidisciplinary teams participated in a postpartum hemorrhage simulation occurring after vaginal delivery. Before participating, each team received checklist training. The primary study outcome was whether each team used the checklist during the simulation. Secondary outcomes were the times taken to activate our institution-specific massive transfusion protocol and commence red blood cell transfusion, and whether a designated checklist reader was used. Results: The majority of teams (12/14 (86%)) used the checklist. Red blood cell transfusion was administered by all teams. The median [IQR] times taken to activate the massive transfusion protocol and transfuse red blood cells were 5 min 14 s [3:23–6:43] and 14 min 40 s [12:56–17:28], respectively. A designated checklist reader was used by 7/12 (58%) teams that used the checklist. Among teams that used a checklist with versus without a designated reader, we observed no differences in the times to activate the massive transfusion protocol or to commence red blood cell transfusion ( P >0.05). Conclusions: Although checklist training was effective in promoting checklist use, multidisciplinary teams varied in their scope of checklist use during a postpartum hemorrhage simulation. Future studies are required to determine whether structured checklist training can result in more standardized checklist use during a postpartum hemorrhage.