Improve Maternal Safety: Real Solutions for Multidisciplinary Education and Training

The Multidisciplinary Nature of Healthcare

Patient care—in any care setting—relies on the attention, dedication, and training of more than one given discipline. Despite this obvious truth, most hospitals and health systems fail to incorporate enough multidisciplinary education and training into their organizations.

Multidisciplinary education and practice occur when several disciplines work in parallel, often with independent goals. Despite having independent goals, one common and ultimate goal is shared by the team—doing what’s best for the patient.

Benefits of Multidisciplinary Education and Training

Studies consistently show that the use of multidisciplinary in-hospital teams limits adverse events, improves outcomes, and adds to patient and employee satisfaction.

A truly multidisciplinary team includes caregivers from different levels of the treatment pyramid (e.g., physicians, pharmacists, surgical technicians, nurses, anesthesiologists, and others). By functioning as a team, the common “silo effect” often present in the healthcare industry is countered with enhanced communication between the different levels of healthcare workers, leading to:

• Reduction in morbidity/mortality
• Decreased length of stay (LOS)
• Fewer adverse events (patient falls, adverse drug events, etc.)
• Improvement in HCAHPS scores
• Increased healthcare worker satisfaction (leading to less burnout and higher retention)

Given the data and support behind multidisciplinary education and team training, it remains insufficient in many care settings.

Challenges and Obstacles With Implementation

Common challenges and obstacles associated with successfully implementing a multidisciplinary education and training program include:

1. Physician resistance

The Challenge: Traditionally, physicians are highly competitive—a characteristic further instilled through education and training. Unlike nurses, physicians typically don’t receive heavy team-based training.

The Approach: That being said, physicians recognize that the traditional hierarchy model is not desirable—that individuals can make mistakes and have “off” days, and with complex systems, relying on one individual brings an inherent fraud with vulnerability. Data certainly helps here—and if physicians see the value in something, they’ll most likely always be on board. Showing the “why” and “how” will clearly and quickly demonstrate the problem organizations are looking to solve and how to best address it.

2. Lack of leadership drive

The Challenge: Without support from leadership, a multidisciplinary education and training program will lack initiation, clarity, and validation—which doesn’t go unnoticed by the care team.

The Approach: Organizational leaders must commit to the implementation, maintenance, and demonstration of results for a multidisciplinary education and training program. In a high reliability organization, commitment to patient safety must start at the top, with commitment following from all levels of healthcare workers. Patient safety initiatives that are presented with a focus on developing a highly effective, well-functioning team will always speak to a leader’s head and heart.

3. Unorganized approach

The Challenge: While attempting to incorporate a multidisciplinary education and training program, organizations often neglect to set clear standards outlining which disciplines/roles will be held accountable, and to what specific standards.

The Approach: By setting well-defined standards, such as “physicians will attend team training with at least two other disciplines per year” or “nurses must complete one multidisciplinary education module every quarter,” organizations can accurately document implementation of a multidisciplinary education and training program. In an environment where adverse events and emergencies occur, the care team understands that time is of the essence and the best and strongest argument for preparation is a team working collaboratively.

A New National Call for Multidisciplinary Education and Training to Improve Maternal Care

Due to the benefits proven through a multidisciplinary education and training program approach, national quality organizations are incorporating this practice into new standards for a variety of care specialties. One of the latest set of standards was developed by The Joint Commission, specific to improving maternal quality and safety.

To foster expedited maternal care improvement, The Joint Commission’s new standards include multidisciplinary education and training, such as criteria including:

• “Provide education to all staff and providers who treat pregnant and postpartum patients about the hospital’s hemorrhage procedure. At a minimum, education occurs at orientation, whenever changes to the procedure occur, or every two years. Note: Education provided should be role-specific.”
• “Conduct drills at least annually to determine system issues as part of ongoing quality improvement efforts. Drills include representation from each discipline identified in the hospital’s hemorrhage response procedure and include a team debrief after the drill.”

Relias–A National Leader in Multidisciplinary Education

Relias OB (formerly GNOSIS™) is truly unique in its multidisciplinary education approach, ensuring that the entire labor and delivery team are following the same evidence-based best practices, allowing them to provide care and communicate as a true team. Relias OB offers a suite of AWHONN-validated and co-authored courses for providers and nurses on promoting vaginal birth, fetal assessment and monitoring, shoulder dystocia, obstetrical hemorrhage, and hypertensive disorders in pregnancy.