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Volume 198, Issue 4, Pages 367.e1-367.e7 (April 2008)


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Articles in fullIntroduction of an obstetric-specific medical emergency team for obstetric crises: implementation and experience

Gabriella G. Gosman, MDaCorresponding Author Informationemail address, Marie R. Baldisseri, MDc, Karen L. Stein, RN, MSEDd, Trish A. Nelson, RN, MHRMd, Susan H. Pedaline, MS, BSNd, Jonathan H. Waters, MDb, Hyagriv N. Simhan, MD, MSCRa

Received 1 March 2007; received in revised form 3 April 2007; accepted 29 June 2007. published online 05 November 2007.

Objective

We describe the implementation and experience with adding an obstetric-specific medical emergency team (called Condition O for obstetric crisis) to an existing rapid response system at Magee-Womens Hospital.

Study Design

In response to deficits identified during patient safety review of adverse obstetric events in 2004 and 2005, the hospital administration decided to add a crisis team with expertise specifically designed for maternal and/or fetal crises.

Results

During the first 6 months, staff rarely called Condition O (14 per 10,000 obstetric admissions). After reeducation efforts, use of Condition O increased to 62 per 10,000 obstetric admissions during 2006.

Conclusion

We outline our hospital’s experience with implementation, efforts to address low utilization, and 1.5 years of Condition O event data. Condition O is a work in progress. In light of this, we discuss the challenges of measuring its patient safety outcome, considerations for team size and composition, and our efforts to determine an optimal Condition O rate.

a Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA

b Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA

c Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA

d Magee-Womens Hospital Patient Care Services, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Corresponding Author InformationReprints: Gabriella G. Gosman, MD, 300 Halket St, Room 2314, Pittsburgh, PA 15213

 Cite this article as: Gosman GG, Baldisseri MR, Stein KL, et al. Introduction of an obstetric-specific medical emergency team for obstetric crises: implementation and experience. Am J Obstet Gynecol 2008;198:367.e1-367.e7.

PII: S0002-9378(07)00849-6

doi:10.1016/j.ajog.2007.06.072


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