Safe Passage: Improving the Transition of Care Between Triage and Labor and Delivery

• Published in: Quality management in health care Vol. 27; no. 4; pp. 223 - 228
• Main Authors: Lee, Daniel D, Colwill, Alyssa C, Teel, Joseph, Srinivas, Sindhu K
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins Ovid Technologies 01-10-2018
• Subjects: Academic Medical Centers - organization & administration; Childbirth & labor; Communication; Continuity of care; Efficiency, Organizational; Emergency services; Female; Health administration; Health care; Health education; Humans; Obstetrics and Gynecology Department, Hospital - organization & administration; Obstetrics and Gynecology Department, Hospital - standards; Patient Safety; Patient Transfer - organization & administration; Patient Transfer - standards; Perinatal care; Pregnancy; Prospective Studies; Quality Improvement - organization & administration; Quality Improvement - standards; Quality of Health Care - organization & administration; Time Factors; Triage - organization & administration; Triage - standards
• ISSN: 1063-8628; 1550-5154
• DOI: 10.1097/QMH.0000000000000191

The multifaceted nature of the transition of care from the triage unit to labor and delivery has historically led to confusion, delays, and errors in care. This study evaluated the effect of standardization of roles and communication on improving this transition.
A multidisciplinary team was assembled to define and standardize roles of team members. A huddle safety board was created as a visual aid to promote closed-loop communication during an admission bedside huddle. The primary metrics collected were duration of time from the admission decision in the triage unit to when the admission huddle was completed on labor and delivery, duration of time from the admission decision in the triage unit to initiation of the plan of care and documented completion of the admission huddle.
There was a 66-minute reduction in time from the admission decision to the huddle completion between the preintervention and postintervention periods. There was a 93-minute reduction in the time from the admission decision to when the plan of care was initiated between the preintervention and post-intervention periods. The weekly huddle compliance rate improved from 48% to 84% by the postintervention period.
The implementation of standardized roles and processes facilitating closed-loop communication decreases delays in communication and initiation of care in pregnant women transferred from the triage unit to labor and delivery.