Annual Program Environmental Scan
The environmental scan consists of 8 sections. Each section has multiple cells of information and associated performance markers. The data is stored in the MOREOB database. Each hospital is able to bench mark its own performance and observe trends over time. The individual hospital is able to compare itself to hospitals of similar size and practice level regionally, provincially and nationally.
The Patient Satisfaction Survey
The Core Team is responsible for conducting an annual, standardized patient satisfaction survey of at least thirty patients in the unit. This survey allows patients to be involved in an assessment of the care provided from a consumer’s perspective. It provides the Core Team and hospital administration with an objective assessment of birthing unit facilities, Programs and staff performance with a view to celebrating strengths and correcting deficiencies.
MOREOB Online Content for Participants
This component contains obstetrical clinical information and relevant patient safety information structured in an interactive format. This enables all participants, regardless of discipline, to enhance their knowledge base to a higher common level, fostering trust and respect and improving communication among all the health care providers. Each chapter is structured in following format:
- Learning objectives
- Clinical core content
- Case exercises
- Glossary of terms
- References and suggested reading
- Decision trees for clinical topics
- Clinical case audit tools
Annual workshop and Objective Structured Consolidation of Education (OSCE) days
Each participant will attend an annual workshop/OSCE day. This component provides the participants with an opportunity to consolidate their MOREOB core content knowledge and to interact with participants from other disciplines in a collegial atmosphere. The interdisciplinary workshops encourage team-building and begin the establishment of Communities of Practice (CoPs).
Annual Culture Assessment Survey (CAS)
The CAS is done Online by each participant at the start of the Program and at the end of each module. The CAS is based on six elements supportive of a patient safety culture. Each element is surveyed with nine specific questions. This tool allows the hospital obstetrical Program Core Team and participants to identify strengths within their culture and opportunities to improve the building and sustaining of a patient safety culture.
Skills Drills
The MOREOB Program provides Skills Drills that permit all participants to practice common birthing unit procedures in a non-stressful environment. The Skills Drills are designed to be used by participants alone, or in small groups. They are particularly useful for individuals (nurses, midwives and physicians) to become familiar with techniques not commonly part of their scope of practice. This provides participants with hands-on experience and prepares them to recognize and anticipate problems. They are also useful in practicing prior to workshops and OSCEs.
Emergency Drills
There are six emergency drills that address the most common obstetrical emergencies. The drills are multidisciplinary exercises that permit the Birthing Unit participants to practice for events that they know will occur. The drills are audited and deficiencies or possible problems can be recognized in a ‘rehearsal’ situation. Emergency drills permit all unit staff to repeatedly practice for these potential occurrences. These exercises also contribute to building team function, trust and respect. They fulfill the HRO principle of rehearsing for emergencies and the unexpected.
Event Tracking and Review
An event-tracking tool, accessible online, provides the opportunity for every participant to identify and report no-harm (near misses) and harm events (incidents and adverse events). Once events are identified, the hospital Core Team will organize multidisciplinary root cause analysis reviews of these cases.
Root Cause Analysis and the Case Analysis Review tool kit
Root Cause Analysis (RCA) is a process of identifying the basic or causal factor(s) that underlie variations in performance, including the occurrence or possible occurrence of a sentinel event. It focuses on systems, not people, and leads the multidisciplinary group through a review of clinical and organizational causes. The process digs deeper by repeatedly asking ‘Why?’ This type of review process identifies changes that could be made in systems to prevent future harm events.
Failure Mode and Effect Analysis (FMEA)
FMEA is a tool that encourages a multidisciplinary team approach to examine routine procedures and processes in a systematic, stepwise, organized manner. Through breaking each clinical process down into its multiple steps and closely examining each step from the viewpoint of ‘What could possibly go wrong here?’ the team can anticipate potential trouble points or deficiencies and repair them before an event occurs.
Audits
An audit form is available at the end of each clinical chapter. These audit tools can be downloaded and made available for use by groups or individuals. They follow the best practice approach presented in the decision trees. Participants in the Program are required to complete audits in each of the modules after Module 1 completion.
- Audits may be completed after successful or problem cases, or as an assessment of unit function in specific topics.
- The Core Team is responsible for assigning audit topics, collecting audit forms, reviewing the audits and leading a process to learn from the audits and introducing change where indicated.
Core Team Fitness Analysis and Team Building Exercises
The Core Team fitness test is a formal instrument to assess the seven elements of effective team function. This analysis along with team building exercises enables the hospital Core Teams to become more effective and efficient in their implementation of the Program.
Communication and Teamwork Tools
A number of specific tools are provided to assist teams in improving interprofessional communication and team functions. e.g. CHAT, briefings, debriefings, checklists, talk-and-do.
