title: Multidisciplinary team training reduces the decision-to-delivery interval for emergency Caesarean section.
abstract: BACKGROUND
  Emergency Caesarean section is performed when the life of the pregnant woman and/or the foetus is considered at risk. A 30-min standard for the decision-to-delivery interval (DDI) is a common practice and is supported by national organisations including The Danish Society of Obstetrics and Gynaecology. Danish obstetric departments report the DDI to a national database. A national arbitrarily set standard recommends that 95% of ECSs should be achieved within the 30-min DDI standard. In 2011, 34.4% of ECSs, performed at our hospital, were achieved within the 30-min time frame. This study aims to evaluate the effect of a simulation-based team training programme on the proportion of ECSs achieved within a 30-min time frame.
  
  
  METHODS
  We performed an interventional before-and-after study. We evaluated a total of one hundred 30-min ECSs before and after the intervention. The primary outcome of interest was the proportion of 30-min ECSs achieved within a 30-min time frame.
  
  
  RESULTS
  A total of 20 team training courses were held during May/June 2013. These courses trained 239 of 252 team members (comprised of: 36 obstetricians, 45 scrub nurses, 83 midwives, 38 anaesthesiologists, 37 nurse anaesthetists) in handling of 30-min ECS. This corresponds to 95% of staff. The proportion of 30-min ECSs achieved within a 30-min time frame was higher after team training (87.5%, 95% CI 79.2-93.4%) compared with before training (74.0%, 95% CI 64.0-82.4%) (P = 0.017).
  
  
  CONCLUSIONS
  Team training may contribute positively to an increase in the proportion of ECSs achieved within a 30-min time frame.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Herlev Hospital, Copenhagen, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Fuhrmann
authors.affiliation: Department of Anaesthesiology and Intensive Care, Herlev Hospital, Copenhagen, Denmark.
authors.forename: T H
authors.initials: TH
authors.lastname: Pedersen
authors.affiliation: Department for Gynaecology and Obstetrics, Herlev Hospital, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Atke
authors.affiliation: Department of Anaesthesiology and Intensive Care, Herlev Hospital, Copenhagen, Denmark.
authors.forename: A M
authors.initials: AM
authors.lastname: Møller
authors.affiliation: Danish Institute for Medical Simulation, Herlev Hospital, Copenhagen, Denmark.
authors.forename: D
authors.initials: D
authors.lastname: Østergaard
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000193:education*; D004630:Emergencies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010348:Patient Care Team; D011247:Pregnancy; D013997:Time Factors