Published online November 1, 2006
PEDIATRICS Vol. 118 Supplement November 2006, pp. S153-S158 (doi:10.1542/peds.2006-0913M)

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ARTICLE

Implementation and Case-Study Results of Potentially Better Practices for Collaboration Between Obstetrics and Neonatology to Achieve Improved Perinatal Outcomes

Mara Zabari, RN, MPA-HA^a, Gautham Suresh, MD^b, Mark Tomlinson, MD^a, Justin P. Lavin, Jr, MD^c, Kristine Larison, RN^a, Louis Halamek, MD^d and Janice A. Schriefer, DrPH^e

^a Department of Perinatology and Neonatal Intensive Care Unit, Providence St Vincent Medical Center, Portland, Oregon
^b Neonatal Intensive Care Unit, Medical University of South Carolina, Charleston, South Carolina
^c Neonatal Intensive Care Unit and Department of Perinatology, Akron Children's Hospital and Akron General Medical Center and Summa Health System, Akron, Ohio
^d Center for Advanced Pediatric Education, Stanford University, Stanford, California
^e Vermont Oxford Network, Burlington, Vermont

OBJECTIVE. The objective of this study was to make improvements in communication and collaboration between neonatal and obstetric specialties. Five NICUs from the Vermont Oxford Network's Evidence-Based Quality Improvement Collaborative in Neonatal and Perinatal Medicine tested potentially better practices that overlap obstetric and NICU care.

METHODS. One area of practice improvement was the management of the pregnancy at the margin of viability. Another included the use of team training and video simulation to improve team performance during high-risk deliveries using aviation-based communication techniques. Another focus of the collaborative was the creation of a multicenter database to measure combined perinatal and neonatal outcomes.

RESULTS. The principle outcomes are increased patient satisfaction with teamwork between neonatology and obstetric services and improved team response times for emergent deliveries and the increased use of team communication skills during video simulations of high-risk deliveries.

CONCLUSIONS. Implementing these potentially better practices can result in improved communication and collaboration related to perinatal and neonatal care.

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Key Words: perinatal • collaborative quality improvement • crew resource management • video simulation • team performance

Abbreviations: VON—Vermont Oxford Network • DHMC—Dartmouth Hitchcock Medical Center • PBP—potentially better practice • IRB—institutional review board

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Accepted Jul 18, 2006.

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