CEO; professor 'Patient safety' at VU University / Amsterdam University Medical Center, the Netherlands
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Publication date
Effect of a cluster randomised team training intervention on adverse perinatal and maternal outcomes: a stepped wedge study.
Romijn, A., Ravelli, A.C.J., Twisk, J.W.R., Wagner, C., Groot, C.J.M. de, Teunissen, P.W. Effect of a cluster randomised team training intervention on adverse perinatal and maternal outcomes: a stepped wedge study. BJOG: International Journal of Obstetrics and Gynaecology: 2019
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Objective
To study the effect of an intervention based on Crew Resource Management team training, including the SBARR tool for structured communication, on adverse perinatal and maternal outcomes.
Design
Stepped wedge.
Setting
the Netherlands.
Population or sample
Registry data of 8 123 women referred from primary‐care to a hospital during childbirth, at ≥32.0 weeks of singleton gestation and with no congenital abnormalities, in the period 2012 to 2015.
Methods
Obstetrical teams of five hospitals and their surrounding primary‐care midwifery practices participated in the intervention. In total 49 team training sessions were organised for 465 care professionals (75,5% participated). Adverse perinatal and maternal outcomes before, during and after the intervention were analysed using multivariate logistic regression analyses.
Main Outcome Measures
Adverse Outcome Index (AOI – 5), a composite measure involving; intrapartum or neonatal death, admission to neonatal intensive care unit, APGAR <7 at 5 minutes, postpartum haemorrhage and/or perineal tear.
Results
In total, an AOI‐5 score was reported in 11.3% of the study population. No significant difference was found in the incidence of the AOI‐5 score after the intervention compared to before the intervention (OR: 1.07: 95%CI 0.92 – 1.24).
To study the effect of an intervention based on Crew Resource Management team training, including the SBARR tool for structured communication, on adverse perinatal and maternal outcomes.
Design
Stepped wedge.
Setting
the Netherlands.
Population or sample
Registry data of 8 123 women referred from primary‐care to a hospital during childbirth, at ≥32.0 weeks of singleton gestation and with no congenital abnormalities, in the period 2012 to 2015.
Methods
Obstetrical teams of five hospitals and their surrounding primary‐care midwifery practices participated in the intervention. In total 49 team training sessions were organised for 465 care professionals (75,5% participated). Adverse perinatal and maternal outcomes before, during and after the intervention were analysed using multivariate logistic regression analyses.
Main Outcome Measures
Adverse Outcome Index (AOI – 5), a composite measure involving; intrapartum or neonatal death, admission to neonatal intensive care unit, APGAR <7 at 5 minutes, postpartum haemorrhage and/or perineal tear.
Results
In total, an AOI‐5 score was reported in 11.3% of the study population. No significant difference was found in the incidence of the AOI‐5 score after the intervention compared to before the intervention (OR: 1.07: 95%CI 0.92 – 1.24).
Objective
To study the effect of an intervention based on Crew Resource Management team training, including the SBARR tool for structured communication, on adverse perinatal and maternal outcomes.
Design
Stepped wedge.
Setting
the Netherlands.
Population or sample
Registry data of 8 123 women referred from primary‐care to a hospital during childbirth, at ≥32.0 weeks of singleton gestation and with no congenital abnormalities, in the period 2012 to 2015.
Methods
Obstetrical teams of five hospitals and their surrounding primary‐care midwifery practices participated in the intervention. In total 49 team training sessions were organised for 465 care professionals (75,5% participated). Adverse perinatal and maternal outcomes before, during and after the intervention were analysed using multivariate logistic regression analyses.
Main Outcome Measures
Adverse Outcome Index (AOI – 5), a composite measure involving; intrapartum or neonatal death, admission to neonatal intensive care unit, APGAR <7 at 5 minutes, postpartum haemorrhage and/or perineal tear.
Results
In total, an AOI‐5 score was reported in 11.3% of the study population. No significant difference was found in the incidence of the AOI‐5 score after the intervention compared to before the intervention (OR: 1.07: 95%CI 0.92 – 1.24).
To study the effect of an intervention based on Crew Resource Management team training, including the SBARR tool for structured communication, on adverse perinatal and maternal outcomes.
Design
Stepped wedge.
Setting
the Netherlands.
Population or sample
Registry data of 8 123 women referred from primary‐care to a hospital during childbirth, at ≥32.0 weeks of singleton gestation and with no congenital abnormalities, in the period 2012 to 2015.
Methods
Obstetrical teams of five hospitals and their surrounding primary‐care midwifery practices participated in the intervention. In total 49 team training sessions were organised for 465 care professionals (75,5% participated). Adverse perinatal and maternal outcomes before, during and after the intervention were analysed using multivariate logistic regression analyses.
Main Outcome Measures
Adverse Outcome Index (AOI – 5), a composite measure involving; intrapartum or neonatal death, admission to neonatal intensive care unit, APGAR <7 at 5 minutes, postpartum haemorrhage and/or perineal tear.
Results
In total, an AOI‐5 score was reported in 11.3% of the study population. No significant difference was found in the incidence of the AOI‐5 score after the intervention compared to before the intervention (OR: 1.07: 95%CI 0.92 – 1.24).