Author: Brendan Carroll, M.D., medical director, obstetrics and gynecology, Providence Portland Medical Center
Laurel Durham, senior director, Providence Women’s Services, Oregon
This summer, women’s health leaders at Providence Portland Medical Center and Providence St. Vincent Medical Center launched TeamBirth – an Ariadne Labs program designed to improve communication among a birthing patient’s care team to ensure a safe, comforting and dignified experience.
Maternal and infant morbidity and mortality rates in the U.S. are both concerning and unacceptable, and racial disparities exist within these overall high rates. Black and American Indian/Alaskan Native women are two to three times more likely to die from a pregnancy-related cause than white women, and infant mortality rates among Black babies are twice that of white babies. Multiple factors contribute to these rates, including structural racism and implicit bias that affect effective communication.
For years, Providence has been taking steps to address birth equity, and TeamBirth is an important piece of the puzzle to ensure that all birthing people have a voice in their care. We believe this will improve experience and outcomes for everyone, as well as reduce disparities in outcomes.
How TeamBirth works
TeamBirth puts into focus what we already do as Providence caregivers – communicate, collaborate and deliver compassionate care – and makes sure it happens consistently with every patient at every birth.
Shared planning whiteboards are added to all labor and delivery rooms where the care team and the patient add information collectively, such as the patient’s concerns and preferences. These whiteboards are updated as needed during TeamBirth bedside huddles throughout labor and delivery. The goal is to empower all members of the care team, including the patient, to play an active role in shared decision-making to improve the safety and quality of care.
This makes everyone feel like they have a say in their birth process. Everybody in the room is encouraged to speak up. Teamwork and communication are really important for patient safety. TeamBirth provides the framework for a simple way that everyone can communicate.
As part of TeamBirth, shared huddles and whiteboards in the labor room aim to:
- Promote the roles of the laboring patient, nurse and delivering provider as members of the care team with equally valuable input for decision-making
- Elicit the patient’s preferences, symptoms and experiences, integrating that with clinical data to inform patient care plans
- Distinguish maternal, fetal and labor progress statuses and care plans
- Set shared expectations of when the group will huddle again
Background
TeamBirth was developed at Ariadne Labs – a joint center for health systems innovation at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, in collaboration with organizations such as the American College of Obstetricians and Gynecologists – to close the gaps that can lead to negative birth outcomes. Ariadne Labs works with communities and public and private sector partners, including health systems, foundations and governments, to implement, evaluate and scale TeamBirth.
Ariadne Labs was founded in 2012 by Atul Gawande, M.D., MPH, and Bill Berry, M.D., MPA, MPH, as a first-of-its-kind joint center for health system innovation. The organization explores new technologies, therapeutics and best practices that can be used to standardize safe, effective care.
Next steps
For Providence in Oregon, we first implemented TeamBirth at our two largest hospitals but the program soon will roll out at Providence Willamette Falls Medical Center and, eventually, at all Providence hospitals in Oregon. Donors through Providence Foundations of Oregon are an important partner in funding the program, and we are deeply grateful for this support.
For more information
https://blog.providence.org/blog-2/our-new-program-puts-you-at-the-center-of-your-birthing-process
Introducing TeamBirth: A Collaborative Approach to Labor and Delivery (video)
https://www.ariadnelabs.org/delivery-decisions-initiative/teambirth/
About the Author
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