title: Perspectives on communication in labor and delivery: a focus group analysis.
abstract: OBJECTIVE
  The objective of this study was to elicit and explore perceptions of barriers to optimal communication among clinicians on a labor and delivery unit, and to use this information to select and design approaches to improve communication.
  
  
  METHODS
  A qualitative research design using a focus group format was utilized. Attending and resident obstetricians and anesthesiologists, as well as staff nurses, pharmacists and unit secretaries participated in the focus groups, which were recorded and transcribed. Data were analyzed using a framework analysis approach.
  
  
  RESULTS
  In total, 18 focus groups with a total of 92 participants were conducted. Eight key themes emerged regarding specific barriers to effective communication among clinicians in the labor and delivery setting. The most prominent of these themes included issues with inter-departmental coordination, clinical accessibility (the ability to reach other clinicians), lack of a consistent approach for clinical documentation, and the involvement of multiple care providers. On the basis of these themes, multiple interventions were designed to enhance communication.
  
  
  CONCLUSIONS
  Focus group methodology can be used to elicit a detailed description of communication practices of clinicians on a labor and delivery unit, permitting an exploration of specific barriers to communication and the identification of potential solutions to those barriers.
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. w-grobman@northwestern.edu
authors.forename: W A
authors.initials: WA
authors.lastname: Grobman
authors.forename: J
authors.initials: J
authors.lastname: Holl
authors.forename: D
authors.initials: D
authors.lastname: Woods
authors.forename: K M
authors.initials: KM
authors.lastname: Gleason
authors.forename: B
authors.initials: B
authors.lastname: Wassilak
authors.forename: M K
authors.initials: MK
authors.lastname: Szekendi
mesh_terms: D003144:Communication Barriers; D003696:Delivery Rooms; D036861:Delivery, Obstetric / Q000592:standards*; D005260:Female; D017144:Focus Groups / Q000379:methods; D055991:Health Records, Personal; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology / Q000592:standards; D009775:Obstetrics and Gynecology Department, Hospital; D010348:Patient Care Team / Q000592:standards*; D010559:Personnel Management / Q000592:standards*; D019555:Physician-Nurse Relations; D011247:Pregnancy; D036301:Qualitative Research; D000078329:Workforce