Using emergency obstetric drills in maternity units as a performance improvement tool.
BACKGROUND
Obstetric drills are being used increasingly to test, improve, and maintain knowledge and skills related to obstetric emergencies as a means to improve proficiency and efficiency of practitioners. The purpose of this study was to assess the feasibility and usefulness of conducting drills to evaluate the response to obstetric emergencies using a holistic approach that tested the hospital system.


METHODS
A prospective trial was conducted at three hospitals (two tertiary referral centers and one small community hospital) in Beirut, Lebanon. Two different emergency obstetric drills at two points in time were conducted between April and May 2006 either in the emergency room or on the labor floor. The drills included medical and paramedical staff, a female actor (simulating a pregnant woman), a research assistant (acting as her companion), and a physician trained in obstetrics (the drill leader). Responses were recorded and critically analyzed.


RESULTS
Although overall quality of care was within standards of care, problems were identified related to hospital policies, supplies and equipment, communication, and clinical management. Some technical problems related to administration of the drills were identified. Most drill participants appreciated the exercise and found it beneficial.


CONCLUSIONS
Obstetric drills provide a useful tool to identify and address deficiencies in the hospital system. This finding could have implications on improving quality of care provided to obstetric patients.
Osman
Hibah
H
Department of Health Behavior and Education and Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Campbell
Oona M R
OM
Nassar
Anwar H
AH
D001291:Attitude of Health Personnel; D036861:Delivery, Obstetric / Q000193:education* / Q000379:methods; D004461:Eclampsia / Q000628:therapy; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D007861:Lebanon; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration*; D016544:Patient Simulation; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000379:methods*; D013647:Task Performance and Analysis; D014592:Uterine Hemorrhage / Q000601:surgery