Brazil V; McLean D; Lowe B; Kordich L; Cullen D; De Araujo V; Eldridge T; Purdy E; 2022 | A relational approach to improving interprofessional teamwork in post-partum haemorrhage (PPH) | To study and support teams improving the care of women with PPH | Junior and senior midwives, junior and senior obstetricians, and anaesthetic doctors. | Gold Coast University Hospital (Southport Australia) | This study revealed poor mutual respect, knowledge sharing and on-time communication among professionals. | The IPC model gave a deeper meaning of productive teamwork and conflict management techniques. Major PPH cases decreased significantly in the labour ward. | Mixed Method research (collaborative action research approach) |
Greer JA; Lutgendorf MA; Ennen CS; Van Petten L; Modzik A; Salas D; Fish J; Middlebrooks R; Spalding CN; Delorey DR; 2023 | Obstetric Simulation Training and Teamwork: Immediate Impact on Knowledge, Teamwork, and Adherence to Haemorrhage Protocols. | To determine the impact of the OB-STaT program on team member knowledge of diagnosis and management of PPH using pretest and post-test scores, assessment of adherence to established PPH protocols, teamwork, and standardized patient perception scores across a nationwide healthcare system using a combination of travelling simulation experts (proctors) and local clinical subject matter experts to train and debrief participants. | Obstetric and gynaecology attending physicians and residents, anaesthesia attending physicians and residents, certified and student nurse anaesthetists, paediatric attending physicians and residents, family practice attending physicians and residents, certified nurse midwives, obstetric and neonatal nurses, Navy hospital corpsmen (who function as medical assistants), blood bank personnel, and operating room personnel | 8 US Navy military treatment facilities (MTFs) within the continental United States that provided delivery services | The training improved PPH recognition and management amongst obstetric teams. Communication, decision-making, situational awareness, and role taking showed a significant improvement following the training. | The multidisciplinary team improved in teamwork and PPH protocol adherence after the OB-STaT program | Prospective, multisite, cohort study |
Wiesehan EC; Keesara SR; Krissberg JR; Main EK; Goldhaber-Fiebert JD; 2023 | State Perinatal Quality Collaborative for Reducing Severe Maternal Morbidity From Hemorrhage: A Cost-Effectiveness Analysis | To evaluate the cost effectiveness of Cal-ifornia’s statewide perinatal quality collaborative forreducing severe maternal morbidity (SMM) from hemor-rhage | Patients' costs records and Nurses in managerial positions who implemented or maintained the PPH–SMM reduction initiative | The state of California | Implementing the PPH–SMM reduction initiative reduced the possibility of complications from PPH and emergency hysterectomy were reduced. | The IPC initiative resulted in a cost effective quality-improvement enterprise that reduced the occurrence of PPH complication in the majority of birthing hospitals. | Evaluative study (Economic analysis) |
Brogaard L; Kierkegaard O; Hvidman L; Jensen KR; Musaeus P; Uldbjerg N; Manser T; 2019 | The importance of non-technical performance for teams managing postpartum haemorrhage:video review of 99 obstetric teams | To analyse videos of obstetrics teams managing real-life patients with major postpartum haemorrhage | Obstetric teams (Obstetricians and Midwives) managing real-life postpartum haemorrhage. | A university hospital and a regional hospital in Denmark | This study revealed that successful management of postpartum haemorrhage depends on well-coordinated interprofessional teamwork. Communication was poor in some teams during the management of PPH, which could jeopardise the success of management as a lot needs to be done in a short space of time. | No results (No IPC model was implemented after the study), but the study recommends continuous interprofessional collaboration and evaluation of teams to prevent PPH. | Observational study (Video review) |
Baayd J; Lloyd M; Garcia G; Smith S; Sylvester H; Clark E; Cross B; Gero A; Cohen S; 2023 | Catalyzing Collaboration Among Interprofessional Birth Transfer Teams Through Simulation | To develop and pilot an interprofessional birth transfer simulation training | Community midwives and doulas, emergency medical technicians, paramedics, emergency dispatch, and hospital-based clinicians (certified nurse-midwives, labour and birth nurses, obstetricians, and maternal-fetal medicine specialists). | Utah USA (one community hospital and one tertiary care centre in an urban setting and one in a rural setting) | The use of simulation assists in improving the skills required to manage PPH without putting any life patient in danger of losing their life. There was a significant improvement in communication among team members during and after simulated training. | Interprofessional training has the potential to improve communication skills, early referral and management of PPH | Participatory design principles and the Boller and Fletcher learning experience design framework |
Lutgendorf MA; Ennen CS; McGlynn A; Spalding CN; Deering S; Delorey DR; Greer JA; 2024 | Interprofessional obstetric simulation training improves postpartum haemorrhage management and decreases maternal morbidity: a before-and-after study | To determine the impact of the Obstetric Simulation Training and Teamwork (OB-STaT) curriculum on postpartum haemorrhage (PPH) rates and outcomes. | Electronic medical records of patients who delivered between February 2018 and November 2019 | Maternity care hospitals within the USA. | Training did not have a significant effect on the decrease of PPH, but there were lower rates of massive transfusions and the transfer time for PPH was shortened. Management of PPH improved after training. | Interprofessional training has a positive effect on multidisciplinary collaboration in the management of PPH | Multi-site before-and-after study |
Nelissen, Ellen; Ersdal, Hege; Mduma, Estomih; Evjen-Olsen, Bjørg; Twisk, Jos; Broerse, Jacqueline; van Roosmalen, Jos; Stekelenburg, Jelle; 2017 | Clinical performance and patient outcomeafter simulation-based training inprevention and management ofpostpartum haemorrhage: an educationalintervention study in a low-resource setting | To assess the effect of obstetric simulation-based training on the incidence of postpartum haemorrhage and clinical performance of basic delivery skills and managementof postpartum haemorrhage in a low-resource setting. | Clinicians, nurse-midwives, medical attendants(nurse aides without formal medical education) and ambulance drivers (without formal education) | Haydom Lutheran Hospital, a rural referral hos-pital in Northern Tanzania | Following the training programme, there was a significant reduction in the incidence of PPH. | No IPC model. | Rospective educational interventionstudy |
Lutgendorf, Monica A; Spalding, Carmen; Drake, Elizabeth; Spence, Dennis; Heaton, Jason O; Morocco, Kristina V; 2017 | Multidisciplinary n Situ Simulation-Based Training as a Postpartum Hemorrhage Quality Improvement Project | To develop and implement a comprehensive, high fidelity, multidisciplinary obstetric simulation exercise to train obstetric providers obstetric anaesthesia providers and labour and delivery nurses in obstetric emergencies. In addition to assessing medical knowledge and technological skills, reinforce teamwork and communication skills and identify improvement areas within our healthcare system. | Obstetric providers: obstetric staff/residents’ midwives, labour and delivery nurses, corpsmen and the remainder were anaesthesia providers | San Diego, City of California | The collaborative training sessions assisted participants in improving teamwork, communication and documentation. | No IPC model was developed during this study | Quality improvement project |
Dillon SJ; Kleinmann W; Fomina Y; Werner B; Schultz S; Klucsarits S; Moreno W; Butsko A; McIntire DD; Nelson DB; 2021 | Does simulation improve clinical performance in management of postpartum haemorrhage? | To examine the clinical performance and outcomes associated with postpartum hemorrhage because of uterine atony following the implementation of a multidisciplinary simulation program | Nursing, obstetrical, and anesthesia providers | Parkland Health, Dallas USA | There was a reduction in intervention time for women who required uterotonic drugs and blood transfusion after the implementation of the simulation program. Teams also managed to identify women who were bleeding excessively in the first 12 hours after delivery. Management of PPH incidents became more uniform and predictable. | Post-partum haemorrhage improved following the implementation of a multidisciplinary simulation program | Prospective observational study |
Egenberg S; Masenga G; Bru LE; Eggebø TM; Mushi C; Massay D; Øian P; 2017 | Impact of multi-professional, scenario-based training on postpartum hemorrhage in Tanzania: a quasi-experimental, pre- vs. post-intervention study. | To determine whether this multi-professional, scenario-based training in managing PPH was associated with changes in blood transfusion rates. | Nurses, midwives, doctors, and medical attendants | Kilimanjaro Christian Medical Centre (KCMC) is a zonal consultant hospital in the northern zone of Tanzania | This study showed an improvement in the management of PPH and a significant reduction in the whole blood transfusion rate after training. | Improved teamwork during emergencies and communication resulted in a higher quality of maternal care. | This quasi-experimental, pre-vs. post-interventional study |
Egenberg S; Karlsen B; Massay D; Kimaro H; Bru LE; 2017 | "No patient should die of PPH just for the lack of training!" Experiences from multi-professional simulation training on postpartum hemorrhage in northern Tanzania: a qualitative study | To enhance understanding and gain knowledge of important learning features and outcomes related to multiprofessional simulation training on PPH | Nurse midwives, doctors, and medical attendants | Northern zone of Tanzania | The multi-professional training resulted in improved management of clinical PPH. | No IPC model was developed during this study | Descriptive and exploratory design |
Bittle M; O'Rourke K; Srinivas SK; 2018 | Interdisciplinary Skills Review Program to Improve Team Responses During Postpartum Hemorrhage. | To develop an interdisciplinary, interactive, skills review program to improve team responses during a postpartum hemorrhage (PPH) | Registered nurses, obstetric and family medicine attending physicians and residents, advanced practice nurses, and ancillary staff | Women's Health Department in a quaternary-care Magnet- and Baby Friendly-designated academic medical center in Philadelphia, Pennsylvania | After the completion of the program team members demonstrated increased confidence and knowledge of the management of PPH. | The program was effective in improving interdisciplinary team responses to PPH | Online didactic modules in combination with an interdisciplinary skills program |
Bell, Amy D.; 22017 | An Interprofessional Obstetric Initiative to Prevent and Reduce Maternal Hemorrhage. | To implement an obstetric hemorrhage protocol with simulation training for multidisciplinary teams across all system facilities; to increase the incidence of completing quantification of blood loss for all births; and to decrease unplanned peripartum hysterectomy rates | Obstetric nursing leaders; obstetric physician leaders; staff from the blood bank, pharmacy, and simulation center; and women who gave birth at these facilities | A multifacility large health care system in Northand South Carolina | Simulation training of multidisciplinary teams related to PPH management reduces the number of women who had unwarranted postpartum hysterectomies, due to the early identification of PPH. | Multidisciplinary teams with nursing and physician champions were formed, obstetric haemorrhage and massive transfusion protocols were created, and mobile simulation of haemorrhage events was more prominent. | Retrospective chart review. |
Main, Elliott K.; Cape, Valerie; Abreo, Anisha; Vasher, Julie; Woods, Amanda; Carpenter, Andrew; Gould, Jeffrey B.; 2017 | Reduction of severe maternal morbidity from hemorrhage using a state perinatal quality collaborative. | To determine whether these safety tools can be scaled up to reduce severe maternal morbidity in women with obstetric haemorrhage using a large maternal quality collaborative | Nurse and physician mentors experienced in quality improvement | California hospitals | A significant reduction in maternal morbidity due to PPH was noticed. | Improved outcomes for women were noted in all hospital types | Before-and-after model |