The Laborhood

Abstract

The purpose of the laborhood was to create a process for daily huddles that included all necessary team members and was practical and efficient to review daily patient care. Create a multidisciplinary huddle that occurs twice daily and is attended by the labor and delivery unit charge nurse, mother–baby charge nurse, NICU charge nurse, perinatal risk nurse, respiratory therapist, neonatologist, anesthesiologist, and the obstetrician covering the labor and delivery unit. The huddle should start on time and its duration is 5 min. The huddle was created by an interdisciplinary team. The huddle was initially done at 8 a.m. and 8 p.m. After a trial of the huddles, changes were made. The huddle time was changed to 7:45 a.m. and 7:45 p.m. after input from the providers. The form used to run the huddle has been changed numerous times after receiving input from huddle members. A high-risk patient—a woman with cardiac disease (who did not disclose this during any prenatal visits)—arrived when she was in labor. She was discussed at the huddle and a plan of care was formed, including telemetry monitoring. Patients with HELLP syndrome (hemolysis–elevated liver enzymes–low platelets counts) can be discussed and a plan for anesthesia developed. The huddle form is now placed in a location where all can see, so staff can look at the huddle and see an overview of the unit. If the anesthesiologist is in the operating room and cannot attend the huddle, he/she will come to the labor and delivery unit when done and review the form with the charge nurse. The staffs’ perception of delivering safe care is measured through our annual culture of safety survey where all criteria increased after laborhood implementation. Nurses have input into the care of their patients. They must have a way to voice their concerns to a multidisciplinary team. This multidisciplinary huddle is a good forum to discuss patients. The nurse can attend the huddle, or the nurse can discuss concerns with the charge nurse, who will bring the information to the huddle. Communication is key to improved outcomes. This huddle is a good form of communication for the care of obstetric patients.