Article

Introduction of an obstetric-specific medical emergency team for obstetric crises: Implementation and experience

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
American journal of obstetrics and gynecology (Impact Factor: 3.97). 05/2008; 198(4):367.e1-7. DOI: 10.1016/j.ajog.2007.06.072
Source: PubMed

ABSTRACT We describe the implementation and experience with adding an obstetric-specific medical emergency team (called Condition O for obstetric crisis) to an existing rapid response system at Magee-Womens Hospital.
In response to deficits identified during patient safety review of adverse obstetric events in 2004 and 2005, the hospital administration decided to add a crisis team with expertise specifically designed for maternal and/or fetal crises.
During the first 6 months, staff rarely called Condition O (14 per 10,000 obstetric admissions). After reeducation efforts, use of Condition O increased to 62 per 10,000 obstetric admissions during 2006.
We outline our hospital's experience with implementation, efforts to address low utilization, and 1.5 years of Condition O event data. Condition O is a work in progress. In light of this, we discuss the challenges of measuring its patient safety outcome, considerations for team size and composition, and our efforts to determine an optimal Condition O rate.

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    • "The emergency team is alerted via a paging system simultaneously. In dire emergency such as massive PPH, this system has successfully delivered early interventions hence improving maternal outcomes (Gosman et al., 2008). A delay in intervention of 20 minutes or more had led to a poorer outcome. "
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    • "The World Health Organization (WHO) estimates that obstetric hemorrhage complicates 10.5% of all live births in the world.[21] Furthermore, 28% of all direct maternal deaths are directly attributable to hemorrhage, with massive obstetric hemorrhage being a major risk factor for severe maternal morbidity and mortality.[171922] "
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    • "These systems have now been widely adopted internationally [5] [6] [7] [8]. They have been extended to cover pediatric [7] [9] [10] [11] [12], obstetric [13] [14] [15], and emergency department patients [16-19]. Within these systems, nursing and/or medical staff can call an emergency team based on prespecified vital sign abnormalities ( " triggers " ) or because they believe the patient is at risk of a serious adverse event ( " worried " criterion). "
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