April 5th, 2020

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A Checklist for Timeout on Labor and Delivery: A Pilot Study to Improve Communication and Safety
Authors:  Kathie L. Hullfish, M.D., Taniqua Miller, M.D., Lisa M. Pastore, Ph.D., Evie Nicholson, R.N., Li Jin, M.D., Sally A. Miller, N.P., C.N.M., Lynne Menei, R.N., Devereux N. Saller, M.D., and James E. Ferguson II, M.D.
  OBJECTIVE: To assess the impact on staff communication of a standardized checklist for timeout for patients undergoing a trial of labor after cesarean section and/or elective induction at term.

STUDY DESIGN: A comparison of presurvey and postsurvey questionnaire results for labor and delivery personnel assessing communication before and after checklist implementation.

RESULTS: From October 2011 through March 2012, 52.9% (N=37) of 70 eligible patients had the standardized checklist for timeout performed. Prior to implementation of the checklist, 66% of respondents (48.8% of nurses, 100% of residents, 90% of attendings) slightly or strongly agreed that their opinions were heard versus 83% of respondents during the study period (73.7% of nurses, 100% of residents, 100% of attendings). Following the intervention, nurses reported that they were more likely to feel as though their opinions were heard (p=0.05).

CONCLUSION: Implementation of a formalized obstetric timeout improved the subjective perception of communication among obstetric staff. This tool has the potential to improve patient safety in labor and delivery.
Keywords:  checklists, communication, induction of labor, patient safety, timeouts, trial of labor after cesarean
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