title: Incorporating the views of obstetric clinicians in implementing evidence-supported labour and delivery suite ward rounds: a case study.
abstract: OBJECTIVE
  To implement evidence-supported delivery suite ward rounds using strategies to overcome barriers.
  
  
  METHODS
  Qualitative case study to identify barriers and a quantitative assessment of outcomes on ward rounds.
  
  
  METHODS
  After an introduction to the proposed evidence-supported delivery suite ward round reactions were elicited from 15 clinicians. Responses were categorized into barriers related to knowledge, skills, attitudes and behaviour. Using strategies to overcome these barriers, a weekly evidence-supported ward round was established. During patient-centred discussions, clinical questions were formulated. Following literature searches, evidence was acquired and appraised.
  
  
  RESULTS
  Clinicians had limited awareness about the potential benefits of a clinical librarian's support during ward rounds. They were unsure of their skills in evidence-based practice. There was scepticism, fear of loss of autonomy, poor motivation and resistance to change. Clinicians identified several factors that could impinge on their practice. Using appropriate strategies when evidence-supported ward rounds were conducted, 67 questions were raised. However only seven articles were appraised in time to affect decisions on that ward round.
  
  
  CONCLUSIONS
  Knowledge of barriers was helpful in developing plans for implementation of evidence-supported ward rounds. The pilot study indicates the feasibility of this approach.
authors.affiliation: Birmingham Women's Health Care NHS Trust, Birmingham, UK.
authors.forename: Neelima
authors.initials: N
authors.lastname: Deshpande
authors.forename: Mary
authors.initials: M
authors.lastname: Publicover
authors.forename: Harry
authors.initials: H
authors.lastname: Gee
authors.forename: Khalid S
authors.initials: KS
authors.lastname: Khan
mesh_terms: D001291:Attitude of Health Personnel; D003657:Decision Making; D003696:Delivery Rooms / Q000592:standards*; D019317:Evidence-Based Medicine / Q000193:education*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016245:Librarians; D007992:Libraries, Hospital; D008505:Medical Staff, Hospital / Q000193:education / Q000523:psychology*; D009774:Obstetrics / Q000193:education* / Q000592:standards; D019982:Organizational Case Studies; D009936:Organizational Innovation; D010348:Patient Care Team; D011247:Pregnancy; D011361:Professional Competence; D036301:Qualitative Research; D006113:United Kingdom