Effectiveness of Communication Interventions in Obstetrics-A Systematic Review.

Sonia Lippke,Franziska Maria Keller,Lukas Kötting,Annalena Welp,Martina Schmiedhofer,Christina Derksen

doi:10.3390/ijerph18052616

Abstract

(1) Background: Obstetric work requires good communication, which can be trained through interventions targeting healthcare providers and pregnant women/patients. This systematic review aims to aggregate the current state of research on communication interventions in obstetrics. (2) Methods: Using the PICOS scheme, we searched for studies published in peer-reviewed journals in English or German between 2000 and 2020. Out of 7018 results, 71 studies were included and evaluated in this synthesis using the Oxford Level of Evidence Scale. (3) Results: The 63 studies that included a communication component revealed a positive effect on different proximal outcomes (i.e., communication skills). Three studies revealed a beneficial effect of communication trainings on distal performance indicators (i.e., patient safety), but only to a limited extent. Most studies simultaneously examined different groups, however, those addressing healthcare providers were more common than those with students (61 vs. 12). Only nine studies targeted expectant mothers. Overall, the evidence level of studies was low (only 11 RCTs), with 24 studies with an evidence level I-II, 35 with level III, and 10 with level IV. (4) Conclusions: Communication trainings should be more frequently applied to improve communication of staff, students, and pregnant women and their partners, thereby improving patient safety.

Highlights

IntroductionMedical errors cause high healthcare costs and negative outcomes for women and their newborn babies [1]
In obstetrics and gynecology, medical errors cause high healthcare costs and negative outcomes for women and their newborn babies [1]
The overarching research question of this review was whether interventions including a communication component have an effect on (a) proximal or (b) distal performance indicators in obstetrics

Summary

Introduction

Medical errors cause high healthcare costs and negative outcomes for women and their newborn babies [1]. Interpersonal and relational communication has been identified as one of four dimensions in midwifery models of care [18] These models consider that—unlike most other reasons to visit a hospital—birth is a natural process in most cases and a joyful moment for the parents, but it can cause uncertainty or fear. Testing research question 2a, whether the interventions were grounded in theory or organizational initiatives, we found the authors reported theory-based approaches in all studies (using implicit or explicit theories concerning simulation, communication, shared decision making, skills training, and error disclosure). This approach was more frequent than organizational initiatives (patient safety culture, safety interventions/training, and organizational targets) with just six studies

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