title: Implementation of an Interprofessional Team Review of Adverse Events in Obstetrics Using a Standardized Computer Tool: A Mixed Methods Study.
abstract: OBJECTIVE
  As part of a larger study, an interprofessional team piloted a computer tool called Standardized Clinical Outcome Review (SCOR) to review adverse obstetric events that occurred at a tertiary care hospital over a 12-month period. We sought to understand whether the SCOR tool offered a feasible, acceptable, and appropriate strategy for improving patient safety through improved review of incidents.
  
  
  METHODS
  We designed a mixed methods implementation study. Following completion of the 12-month pilot period, team members completed a questionnaire and participated in a focus group. Quantitative data analysis was performed using descriptive statistics, and qualitative data were analyzed using grounded theory to generate themes.
  
  
  RESULTS
  The SCOR tool was easy to implement with an interprofessional team. Despite technical challenges with the software, the tool was quicker and more efficient than traditional case review methods. The content was appropriate for an obstetric unit and provided objective identification of factors contributing to adverse events. Team members were positive about the use of the tool in their institution and in wider contexts and believed that it was a valuable tool for raising awareness and addressing patient safety at their unit.
  
  
  CONCLUSIONS
  SCOR was an acceptable and appropriate tool for the interprofessional team review of adverse outcomes, and its use represents a significant advance in the quality assurance process for formal peer review of incidents.
authors.affiliation: Department of Obstetrics and Gynecology, McMaster University, Hamilton ON; Midwifery Education Program, McMaster University, Hamilton ON.
authors.forename: Beth
authors.initials: B
authors.lastname: Murray-Davis
authors.affiliation: Midwifery Education Program, McMaster University, Hamilton ON; Department of Family Medicine, McMaster University, Hamilton ON.
authors.forename: Helen
authors.initials: H
authors.lastname: McDonald
authors.affiliation: West Midlands Perinatal Institute, Birmingham UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Cross-Sudworth
authors.affiliation: Department of Obstetrics and Gynecology, McMaster University, Hamilton ON.
authors.forename: Sharon
authors.initials: S
authors.lastname: Dore
authors.affiliation: Department of Pediatrics, McMaster University, Hamilton ON; Division of Neonatology, McMaster Children's Hospital, Hamilton ON.
authors.forename: Michael
authors.initials: M
authors.lastname: Marrin
authors.affiliation: Division of Women's Health, Hamilton Health Sciences, Hamilton ON.
authors.forename: Judy
authors.initials: J
authors.lastname: DeSantis
authors.affiliation: Division of Women's Health, Hamilton Health Sciences, Hamilton ON.
authors.forename: Lisa
authors.initials: L
authors.lastname: Sabatino
authors.affiliation: Department of Obstetrics and Gynecology, McMaster University, Hamilton ON; Division of Maternal Fetal Medicine, McMaster University, Hamilton ON.
authors.forename: Bryon
authors.initials: B
authors.lastname: DeFrance
authors.affiliation: Department of Obstetrics and Gynecology, McMaster University, Hamilton ON.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Leyland
authors.affiliation: West Midlands Perinatal Institute, Birmingham UK; Department of Maternal and Perinatal Health, University of Warwick, Coventry UK.
authors.forename: Jason
authors.initials: J
authors.lastname: Gardosi
authors.affiliation: Department of Obstetrics and Gynecology, McMaster University, Hamilton ON; Midwifery Education Program, McMaster University, Hamilton ON; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton ON.
authors.forename: Eileen
authors.initials: E
authors.lastname: Hutton
authors.affiliation: Department of Obstetrics and Gynecology, McMaster University, Hamilton ON; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton ON; Division of Maternal Fetal Medicine, McMaster University, Hamilton ON; Department of Radiology, McMaster University, Hamilton ON.
authors.forename: Sarah
authors.initials: S
authors.lastname: McDonald
mesh_terms: D005260:Female; D006801:Humans; D008491:Medical Informatics Applications; D009774:Obstetrics / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D010348:Patient Care Team; D061214:Patient Safety; D011247:Pregnancy; D011785:Quality Assurance, Health Care; D012984:Software
keywords: Quality assurance; mixed methods; patient safety