Abstract
Cesarean delivery is the most common surgery performed in the United States, accounting for approximately 32% of all births. Emergency Cesarean deliveries are performed in the event of critical maternal or fetal distress and require effective collaboration and coordination of care by a multidisciplinary team with a high level of technical expertise. It is not well understood how the physical environment of the operating room (OR) impacts performance and how specialties work together in the space.ObjectiveThis study aimed to begin to address this gap using validated techniques in human factors to perform a participatory user-centered analysis of physical space during emergency Cesarean.MethodsThis study employed a mixed-methods design. Focus group interviews and surveys were administered to a convenience sample (n = 34) of multidisciplinary obstetric teams. Data collected from focus group interviews were used to perform a task and equipment analysis. Survey data were coded and mapped by specialty to identify reported areas of congestion and time spent, and to identify themes related to physical space of the OR and labor and delivery unit.ResultsTask analysis revealed complex interdependencies between specialties. Thirty task groupings requiring over 20 pieces of equipment were identified. Perceived areas of congestion and areas of time spent in the OR varied by clinical specialty. The following categories emerged as main challenges encountered during an emergency Cesarean: 1) size of physical space and equipment, 2) layout and orientation, and 3) patient transport.ConclusionUser insights on physical space and workflow processes during emergency Cesarean section at the institution studied revealed challenges related to getting the patients into the OR expediently and having space to perform tasks without crowding or staff injury. By utilizing human factors techniques, other institutions may build upon our findings to improve safety during emergency situations on labor and delivery.
Highlights
Cesarean delivery is the most common surgery performed in the United States, accounting for approximately 32% of all births [1, 2]
By utilizing human factors techniques, other institutions may build upon our findings to improve safety during emergency situations on labor and delivery
This study was approved by the Institutional Review Board (IRB) of Stanford University
Summary
Cesarean delivery is the most common surgery performed in the United States, accounting for approximately 32% of all births [1, 2]. The standard for urgent Cesarean is delivery of the fetus within 30 minutes after the obstetrician decides that operative delivery is indicated [3] This recognizes that time is required to mobilize the obstetric, anesthesia and pediatric teams, move the patient to an operating room (OR), ensure an appropriate level of anesthesia, and deliver the fetus; this timing is challenging to achieve [4,5,6]. Emergency Cesarean deliveries are performed when an unforeseen complication arises during the labor process and time is of the essence This complex and stressful procedure requires effective communication, coordination of multidisciplinary teams, technical expertise, and the ability to make decisions quickly and perform tasks efficiently under time pressure. Emergency Cesarean deliveries require a high level of human and system performance, and it is not well understood how the design of the physical environment assists or impedes performance
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
