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Development of a new interdisciplinary teamwork assessment scale for obstetric crisis management
Abstract Number: F-19
Abstract Type: Original Research
It is now recognized that non-technical errors are a cause of morbidity and mortality in obstetric health care.1 2004-2012 Root Cause analysis data from the American Joint Commission showed that communication is responsible for greater than 50% of overall sentinel events, with 82% events in 2010, 61% in 2011, and 58% in 2012. Of note, communication errors contributed to 50% of maternal sentinel events.2
An extensive literature search showed that there is currently no validated interdisciplinary obstetric teamwork assessment scale used in the simulation setting. Our aim was to design a new obstetric interdisciplinary teamwork scale and establish its face and content validity using a modified Delphi technique.
After REB approval, a new assessment scale was designed. The scale was sent out electronically to an international selected panel of experts comprising of obstetric anesthesiologists, obstetricians and nurses. The Delphi process required participants to indicate agreement for or against each component of the scale, and also volunteer additional relevant comments. Each statement was analyzed quantitatively by the percentage of agreement ratings and each comment reviewed by the blinded investigators. The assessment scale was then modified, with components of less than 80% agreement removed from the scale. This was sent to the experts again for the 2nd round. It is now being sent out for the 3rd round.
Twenty four external raters were invited to take part in the Delphi process, of which 14 participated. The initial scale comprised of 7 main domains: Shared Mental Model, Communication, Situational Awareness, Leadership, Followership, Workload Management, and Positive/Effective Behaviors and attitudes. In addition, there was a Global score. The initial total number of items was 40. In the 1st round 3 items were removed, and 10 items rephrased. In the 2nd round, 4 items were removed and five items rephrased. The results of 3rd round are awaited and will be presented at the SOAP meeting.
Using a modified Delphi technique, we have obtained a consensus agreement on the items in our new teamwork scale. We have established face and content validity that focuses on non-technical skills.
1. Wong CA. Saving mothers' lives: the 2006-8 anaesthesia perspective. British journal of anaesthesia. Aug 2011;107(2):119-122.
2. The Joint Commission: Sentinal Event Data Root Causes by event type 2004-2012. 2012.