What Are Team Meetings?
Team Meetings are structured communication events that help to increase patient safety in real-time. They are also referred to as briefings, regularly occurring meetings in which multidisciplinary team members come together to review team roles, the plan of care for all the patients on the unit, highlight any safety concerns, and discuss staffing, resources, and the overall status of the unit (Agency for Healthcare Research and Quality, 2012). This should ideally take place at a minimum of once per shift.
What Do They Look Like?
On a labor and delivery unit in a teaching hospital they might look like this:
- Every available nurse attends the meeting and does a quick SBAR report out and remains at the meeting the entire duration
- Other team members consist of residents, laborists, private physicians with patients on the unit, neonatal intensive care providers, and medical/nursing leadership
- Team discussion takes place regarding:
- Potential or actual upcoming cesarean deliveries or operative procedures (version, cerclage, vacuum/forceps delivery, etc.) and any shifting of resources required such as nurses changing assignments
- Staffing and coverage (i.e. residents off the unit or laborist in a C-section and backup coverage)
- Postpartum hemorrhage risk levels and plans for high-risk patients
- Any abnormalities noted including but not limited to prolonged labors, abnormal vital signs, or concerns for a shoulder dystocia
Two Heads Are Better than One
Team meetings offer an opportunity for all members to weigh in and contribute to patient scenarios and plans of care, including situations that may be out of the norm, thus increasing patient safety. For example, during a labor and delivery team meeting a nurse discusses that her patient has completed her recovery period status post vaginal delivery and is being monitored for a longer duration on the unit secondary to increased pain. This leads to a team discussion of pain location, presence of episiotomy/lacerations, pre-existing pain control issues/dependence on medications, timing related to delivery, and considerations for etiology including vaginal hematoma.
As a result, the provider is contacted to evaluate the patient at the bedside, diagnoses a vaginal side-wall hematoma, and the decision is made to monitor her closely on the labor unit for several more hours. Once she is ready for transfer to postpartum, this information is included in the shift to shift report and everyone is aware of this patient including residents, laborists, and charge nurses. No further interventions are necessary and the patient has no other complications. Hence, this demonstrates how team meetings can allow for increased communication, and the opportunity to capitalize on the strengths of others in the group, potentially mitigating complications and resulting in a safer care environment.
References
Agency for Healthcare Research and Quality (2012). Team Strategies & Tools to Enhance Performance & Patient Safety (TeamSTEPPS®) 2.0. TeamSTEPPS Fundamentals Course: Module 4. Leading Teams. Retrieved from https://www.ahrq.gov/teamstepps/instructor/fundamentals/module4/igleadership.html#im13
Copyright by Jeanette Zocco MSN, RNC-OB, C-EFM, C-ONQS