Engaging Frontline Staff in Process Improvement: Increasing Utilization of the Obstetrical Emergency Team

Purpose:
Through monthly call analysis, we determined that our Obstetrical Emergency Team (OBET) was underutilized. Leadership and frontline staff worked collaboratively to develop strategies to increase our utilization of this innovative emergency response team, which is vital to improve patient outcomes.

Significance:
Utilization of the multidisciplinary OBET was crucial to improve response times for obstetrical emergencies. Engagement of the front line staff in this improvement process was essential to understand the barriers encountered with the current system in order for changes to be implemented.

Strategy and Implementation:
To accurately identify the barriers to achieving the potential benefits the OBET had to offer, it was necessary to engage the expertise of the frontline staff. A team including staff RNs, quality consultant, educators, dispatchers and management worked collaboratively to identify obstacles faced by staff initiating calls for the OBET. Staff feedback was solicited via meetings, audio tape review, safety rounding, e-mail, and individual conversations. Problems identified included: phone issues, call durations, team being dispatched to the wrong location, and the periodic inability of callers to correctly identify their location. These issues often caused delays in mobilizing the team. Discussions with staff revealed a lack of trust in the system that was designed to improve care. Open communication led to changes which included: OBET signage in each patient room, phone model upgrade, improved dispatcher understanding of the obstetrical unit layout, and an abridged dispatch algorithm.

Evaluation:
Since the multifactorial changes have been applied to the system, the volume of OBET calls has more than tripled over the last year, as validated by call and data analysis. Staff feedback has shown an improved trust in the OBET, which is imperative for staff buy-in and success.

Implications for Practice:
While the motivation of this endeavor was to increase the utilization of our emergency response team, it is evident that valuing the feedback and expertise of frontline staff is essential to drive successful change. This approach can be translated into any improvement effort across healthcare.