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The Sullivan Group's e–Learning Newsletter
August 2013 - In This Issue

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Dan
Thank you for reviewing INSIGHT, a newsletter outlining news and events at The Sullivan Group, and providing valuable advice and tips from the esteemed members of our Advisory Board.  
 
We hope you enjoy our inaugural edition.

Dan Sullivan, MD, JD, FACEP
President & CEO


SAVING
LIVES
REDUCING RISK
Leveraging Continuing Education for Nurses & Physicians to bring about meaningful change.

The Sullivan Group offers a series of scalable, comprehensive loss prevention and patient safety programs, specifically targeted at reducing medical errors and malpractice claims across the spectrum of high-risk medicine.

The RSQ® Solutions (Risk–Safety–Quality) programs are tailored for a variety of medical and nursing specialties and based on a proven cyclical model of continuous quality improvement that drives change, strengthens clinical performance, and reduces risk exposure.
What's New?

We are pleased to announce the release of updates to the following courses:

  • Myocardial Infarction, Part 1
  • Myocardial Infarction, Part 2
  • Pulmonary Embolism, Part 1
  • Thoracic Aortic Dissection
  • Stroke Literature Review: Acute Stroke Management with Thrombolysis
  • Stroke Part 1

**Signifcant Updates! The latest evidence-based medicine best practices were added to each of the courses listed above. **

CME Courses in Development
The TSG faculty and staff are currently working on the following courses. We will keep you posted on our progress, but please do not hesitate to contact us to learn more about what we have planned for each topic.

  • Disclosure & Early Resolution Programs
  • Communicating Bad News
  • Handoffs, Transitions & Discharges: Key Moments in Patient Care - LAUNCHED!
  • Workplace Violence, Disruptive Behavior & Hostile Environment in Healthcare

New Team Member
Please join us in welcoming Karen Ragland to the TSG team. Karen is responsible for risk management and patient safety e–Learning client engagement. Contact Karen

Upcoming Events

VCIA's Annual Conference: Aug. 13–15, 2013, Sheraton Hotel & Conference Center (Burlington, VT)

ENA Conference: Sept. 17–19, 2013, Gaylord Opryland Resort & Convention Center (Nashville, TN)

ACEP Scientific Assembly: Oct. 14–17, 2013, Washington State Convention Center (Seattle, WA) Booth No. 825

ASHRM Annual Conference: Oct. 27–30, 2013, Austin Convention Center (Austin, TX) Booth No. 601

IMAC Cayman Captive: Dec. 3–5, 2013, The Ritz Carlton (Grand Cayman)

 

Faculty Speaking Engagements

Meet Shelley Cohen, RN, MSN, CEN, on September 10, 2013. She is presenting the New Manager Intensive at the Nursing Management Congress in Chicago.

Dan Sullivan, MD, JD, FACEP, Tom Syzek, MD, FACEP, and Doug Finefrock, DO, are all speaking at ACEP.


Webinars
We are conducting webinars to provide an overview of some of the latest product releases and enhancements on the following dates. Please join us.

  • August 20th, 1:00pm ET
  • August 27th, 1:00pm ET
  • September 3rd, 1:00pm ET

Please RSVP to Karen Ragland (kragland@thesullivangroup.com).


"We couldn't be more pleased with our relationship with The Sullivan Group. Their risk education has been a hit with our practitioners and combined with the clinical risk assessment tool, we have been able to provide a comprehensive and very focused loss prevention program for our EDs. Now with a decade of claims data across 160 facilities, the data show a strong correlation between success in the program and our approximately 60% reduction in claims frequency. "

 

Joseph Haase, CPHRM, President, HCI, Inc. (Hospital Corporation of America)

 

Our Advisory Board
Doug Finefrock, DO
Patient Satisfaction
DougImproving the Patient Experience

Improving the Patient Experience is currently among the top three priorities in most healthcare facilities. Best practices in patient satisfaction:

  1. Prevent lawsuits;
  2. Deliver the highest HCAHPS scores for CMS payments, and;
  3. Maximize the satisfaction of both the patient and provider.

In response to this industry need, we've developed a series of courses to help healthcare professionals understand how to implement best practices. The PatientSET™ courses use multimedia video demonstrations of techniques to deliver consistent, compassionate care to patients in various healthcare settings. We explain the evidence behind our techniques and introduce the PatientSET™ List "Satisfaction Every Time," a consistent systematic approach to patient encounters that is organized into three simple stages of care.

Follow Doug Like us on Facebook Follow us on Twitter View our profile on LinkedIn 
Website: DrFinefrock.com
Follow this topic: PatientSET Follow us on Twitter

Featured Courses:

  • PatientSET™ #1: Introduction for All Healthcare Providers
  • PatientSET™ #2: Hospital Best Practice High-Risk Videos
  • PatientSET™ #2: Office Best Practice High-Risk Videos
  • PatientSET™ #4: Introduction for Nurses – in development
  • PatientSET™ #5: HCAHPS Videos for Nurses – in development
  • PatientSET™ #6: Healthcare Customer Service Videos for Nurses – in development
  • PatientSET™ #7: Healthcare Customer Service Videos for Other Employees – in development
  • PatientSET™ #8: Healthcare Customer Service Videos for Triage Nurses – in development

Click Here for a Preview of a Course (this will open up a Flash Player window)

*Note: Shelley Cohen, RN, MSN, CEN, collaborates with Doug on the development of the patient satisfaction courses for nursing.


Shelley Cohen, RN, MSN, CEN
Triage Nursing
Shelley

Triage Tip Of The Month

Where’s the evidence?

As the knowledge base related to emergency nursing continues to grow, a common question can be heard: "Where's the evidence?" As triage nurses, we know from experience that many of our decisions are based on that brief snapshot of patients when they initially present; a key word they use, their anxiety, a spoken fear of wanting to harm themselves or others is often the red flag we use in our decision–making.
Recognize that evidence does not exist for every single thing we do in emergency nursing, and learn the difference between a best practice and evidence-based practices.

  • Evidence-based practice: The conscientious use of current best evidence in making decisions about patient care.
  • Best practice: A generic or general phrase for a process of infusing nursing practice with research-based knowledge.

Sources:
Hollander, Judd, 2013. Annals of Emergency Medicine. 61 (2), pages 196-197.
Melnyk, Bernadette, et al. Evidence-based practice in nursing & healthcare. Philadelphia: Lippincott Williams & Wilkins. 2005.
University of Iowa College of Nursing. Retrieved from: http://www.nursing.uiowa.edu/hartford/best-practices-for-healthcare-professionals


Follow Shelley Follow us on Twitter View our profile on LinkedIn Like us on Facebook
Follow this topic: RSQ_TriageSTAT Follow us on Twitter

Featured Courses:
  • Triage Fundamentals: A comprehensive suite of courses (ranging in length from one to two hours) targeting risk issues in triage nursing. Seven of the eleven courses are live, and cover topics such as The Risky Business of Triage, practice standards, assessment and documentation, etc.  
  • PatientSET™ #6: Healthcare Customer Service Videos for Nurses – in development
  • PatientSET™ #7: Healthcare Customer Service Videos for Other Employees – in development
  • PatientSET™ #8: Healthcare Customer Service Videos for Triage Nurses – in development

Click here to access a list of all Triage courses.

Arnie Mackles, MD, MBA, LHRM
Risk Management & Patient Safety
Arnold Mackels, MD, MBA Creating a Culture for Patient Safety

Leveraging the proliferation of evidence–based best practices for the clinical provision of care in the risk management arena, we have identified the following root causes for patient harm (and resultant claims) and mapped each to a course offered by The Sullivan Group.

1)    Communication failures between care providers during handoffs, as well as between providers and patients at transition points of care remain a significant cause of patient injury and/or death.

  • TSG e-Learning Response: Communication Strategies to Improve Patient Safety in High-Risk Situations

2)    Patients returning to the hospital following discharge because they misunderstand the discharge instructions.

  • TSG e-Learning Response: Handoffs, Transitions & Discharges: Key Moments in Patient Care (NEW!)

3)    Medication errors due to staff miscommunication.

  • TSG e-Learning Response: 11 Simple Strategies to Prevent Medication Errors

4)    Barriers to utilization and optimization of innovative patient safety technology to improve communication, reduce errors, and improve quality of care.

  • TSG e-Learning Response: Technology Revolution: Improving Patient Safety, Reducing Liability

5)    Gaps in provider education concerning fundamental patient safety principles, including communication techniques and patient safety strategies to decrease risk, reduce medical errors and provide optimum patient care.

  • TSG e-Learning Response: Essentials of Patient Safety, Prevention of Medical Errors

 

 

Follow Arnie View our profile on LinkedIn

Website www.drmackles.com
Follow this topic: RSQ_Education
 Follow us on Twitter


Featured Courses:
  • Essentials of Patient Safety
  • Communication Strategies to Improve Patient Safety in High-Risk Situations
  • 11 Simple Strategies to Prevent Medication Errors
  • Technology Revolution: Improving Patient Safety, Reducing Liability

Click here to review all of the courses available under this topical area.

Henry Lerner, MD
Obstetrics
Henry A Distressed Labor & Delivery Unit

Dr. Mary Smith, the Chair of the Obstetrics and Gynecology department at County Hospital, was en route to a meeting with Dr. John Bart, Chief Medical Officer. The purpose of the meeting was to review patient complaints originating out of her service. While waiting for the elevator, Dr. Smith was hurriedly approached by an obviously distressed Susan Jones, the L&D head nurse.

"We had another bad outcome last night,” said the head nurse. “We had to send another baby up to the NICU.”

"What happened?" asked Dr. Smith.

"We had one of our new grads taking care of the patient in room 5. The charge nurse had been looking in intermittently, but when Dr. Brown was called for delivery at 6:00 am, he was shocked at what the strip showed for the two preceding hours. The baby came out with Apgars of one and three and had to have a full resuscitation; we’re not sure what the outcome is going to be.”

“But we got lucky with another one," the head nurse continued. “There was a shoulder dystocia in room 2 with Dr. White, the new physician. It was a flail. Fortunately, Dr. Jane happened to be around; she walked into the room after they had been struggling for 3.5 minutes and immediately got the baby out. I have no idea what would have happened if she hadn’t come along."

Dr. Smith continued on to Dr. Bart’s office. When she arrived, he waved her in.

"We've been getting some disturbing reports about outcomes in your department, Dr. Smith. Reports from the neonatologist about an increase in resuscitations; numerous patients returning to the OR after cesarean sections and routine deliveries; and far too many cases falling through the quality-assurance screen. As if this were not concerning enough, I’ll go on to note that there is a disturbing spike in incident reports citing inappropriate physician behavior and our patient satisfaction levels are falling. It has escalated to the point that third-party payors are threatening to withhold full reimbursement for our maternity patients. And to top it off, a reporter from the local paper is nosing around. The Board is breathing down my neck; we are about to break ground on the new outpatient surgical wing and we cannot afford this type of negative press – it will crush our fundraising efforts. What's going on in your department?"

"I'm not totally sure, Dr. Bart,” responded Dr. Smith. “Most of our obstetricians have been here for years; they’re experienced and have thriving practices. All of the newly privileged doctors are well trained and come highly recommended. We have a three-month new nurse orientation program. And all of our departmental protocols follow ACOG guidelines to the letter."

"Okay, well I’m glad things look good on the surface, but let's take a closer look at the issues reported," said Dr. Bart. "Babies with low Apgar scores after routine deliveries, complaints that the management of shoulder dystocias and postpartum hemorrhage emergencies is chaotic, missed medical problems and drug allergies because medical records aren't getting to your floor from the offices, and reports of an increasingly hostile attitude between your doctors and nurses.

“Maybe it’s time for us to get some outside help to evaluate our Labor and Delivery operation more comprehensively."

Dr. Smith leaned forward in her chair and was about to voice protest, but instead took a deep breath and settled back in the chair. Dr. Bart was right; things were not going well in County’s L&D unit, and as difficult as it was to acknowledge, perhaps outside help was needed – they can no longer turn a blind eye.

Unfortunately, the situation in this obstetrics department is not unique. A department needs a lot more than experienced obstetricians and adherence to clinical protocols to provide high-level obstetric care.

Leading a safe, high-quality obstetrics unit is a complex task. Multiple goals have to be met: safe and appropriate care for both low- and high-risk obstetrical patients; the ability to handle a large volume of laboring women in a caring and friendly manner; and the ability of the team to shift its mindset immediately when a normal labor becomes an acute obstetrical emergency in order to implement the very precise actions necessary for a good outcome for mother and baby.

Physicians, midwives and nurses require many skills to accomplish these tasks: up-to-date clinical knowledge; sufficient clinical experience to recognize all aspects of developing obstetrical complications; the transparent sharing of responsibility among team members caring for laboring patients; and good communication skills.

It is essential for hospital administration to provide resources in order for the obstetrical team to maintain these skills:

  • Necessary equipment and adequate staffing available 24/7
  • A comprehensive, practical, and ongoing educational program
  • Training to develop optimal working relationships and communications between all members of the obstetric staff so they can work together as a functional, efficient medical team

Making the Decision to Improve

How does a hospital go about creating such an efficient, smooth-running, emergency-ready obstetrical unit?

1. Commitment

The first and most vital part of any obstetrics department improvement project is a conscious decision by both obstetrical department leadership and hospital administration that they are committed to this goal. Such a project can be expensive, both financially and in terms of the time it will take to change long-established behavior patterns and customs of the L&D unit. It will take the full support of - and pressure from - hospital and departmental leadership to achieve buy-in from obstetricians, midwives and staff nurses. As with any change, there will be opposition. In order to succeed, hospital administration will need to be firm; either obstetric team members comply and cooperate with the new way of doing things or they will be replaced.

Hospital administration must commit the finances to provide adequate, experienced staffing with appropriate supervision 24/7. Labor and delivery units are frequently inadequately staffed, especially on nights and weekends. Moreover, since shifts are usually assigned on a seniority basis, nurses working nights and weekends are often the most inexperienced; these are also the times when they have the least supervision. It is logical to deduce that mistakes may be more prevalent and potential problems will likely go undetected when novice nurses are overwhelmed by high patient volumes.

2. Outside Evaluation

Depending on how serious the problems with a labor and delivery unit are and the resources available to the institution, outside consultation by an experienced obstetrician may be needed. The ideal characteristics of such a consultant would be:

  • Clinical expertise in obstetrics with particular emphasis on current best practices and protocols
  • Demonstrated experience in clinical practice
  • Administrative and management proficiency
  • Familiarity with a large range of obstetrical institutions and practice settings
  • Interpersonal, communication and leadership skills

It can be cost effective to use an experienced consultant who has performed other obstetrical unit evaluations, identified deficiencies at those institutions, and presented workable recommendations; otherwise the institution would need to spend time and resources to develop its own obstetrical reform program. A well-qualified, experienced consultant can quickly spot major problematic areas and will be familiar with a range of potential solutions.

3. Leadership

Administrative leadership in the obstetrics and gynecology department will have to be evaluated from top to bottom.

  • Is the departmental chief someone who can lead an obstetrics department improvement project?
  • Or is the fact that the department is underperforming a sign that the current chief is not the right person for the job?

The same goes for nursing leadership.

  • Are the nurse managers knowledgeable, efficient and capable of supporting their nursing staff?
  • Are they respected by administration, obstetricians and the nurses who work for them?

While hospital administration should be prepared to change leadership personnel when an obstetrics department improvement project is initiated, it is not always necessary to do so. The current leadership may be very capable and able to perform once the new processes, protocols and tools are in place. Therefore, careful consideration should be given before contemplating a change in leadership.

4. Data Gathering

It is necessary to thoroughly analyze a department’s performance and develop an improvement plan appropriate for that specific L&D unit. A hospital should not undertake an obstetrics department improvement project based simply on anecdotal perceptions about the department’s poor outcomes, occasional badly handled emergencies or a sense that the next obstetrical disaster is just around the corner.

It is essential to conduct a quantitative evaluation of labor and delivery performance prior to beginning any obstetrical department improvement program, and this requires gathering data. It is only in this way that the full extent of problems within the department can be recognized and that priorities for fixing the most significant issues can be set.

This quantitative evaluation is best undertaken by a comprehensive evaluation of multiple facets of the L&D unit’s operations. It is not sufficient to simply review cases that fall through the quality assurance process or look at the self-reported incidents by staff members and/or Press Ganey/HCAHPS patient satisfaction reports. These evaluation tools, while useful for the intended purpose, alone are not sufficient to measure the scope of complete obstetrical care; they would miss deficient aspects of care such as lack of adherence to protocols, unavailability of important medical records on the L&D floor, misinterpretation of electronic fetal monitor strips, poor team performance during emergencies, etc.

The best means of evaluating the full range of key obstetrical indicators is to use a comprehensive audit tool that covers all areas of patient care in L&D (including prenatal care). An institution could develop its own audit instrument, but such a process would be expensive and time-consuming. There are several excellent commercially available L&D audit programs that that have been used satisfactorily throughout the United States.

Implementing Improvement

Once an institution has committed to obstetrical department reform, leadership has been evaluated and either changed or retained, and a comprehensive audit of the performance of the L&D unit has been completed, it’s time to implement the necessary tools to correct the deficits the audit has uncovered and maximize the quality and safety of care provided by the L&D unit.

1. Education

The foundation for provision of excellent obstetrical care is a thorough and up-to-date clinical knowledge base for all obstetricians, midwives and nurses. Previously learned best practices become outdated as new and better protocols and procedures are established. Practitioners who completed their training 10, 20, even 30 years ago and do not keep up with current knowledge at the least may not be practicing good obstetrics despite years of clinical experience, and at worst may be putting their patients in harm’s way and exposing their colleagues, other staff members and organizations to potential negligence claims.

There are multiple means of providing ongoing education for physicians and nursing staff. For example:

  • L&D units can implement weekly teaching sessions that cover important topics in clinical obstetrics over the course of a one- or two-year period; these can be taught either by members of the department or outside speakers.
  • All obstetric team members should be encouraged to attend obstetrical conferences and regularly read obstetrical journals; they should be given access to online resources such as UpToDate.
  • Online courses are a very efficient tool for ongoing clinician education and are growing in popularity. There are currently a great variety of e-Learning courses available that can be accessed from any computer, tablet or other web-capable device. Courses offered by industry leaders are well written, interactive, illustrated, and user-friendly. They offer tremendous flexibility, as they can be taken at any time of the day or night and from any location with an Internet connection. Learners will find that they cover a wide range of topics, from the handling of obstetrical emergencies to the pathophysiology of obstetrical complications. As with conferences and journals, continuing education credits are usually awarded for online course completion.

Hospital or obstetrical department leadership will have to convince busy obstetricians and nurses to participate in such educational programs, especially when the obstetrical staff consists of private practitioners; but this must be accomplished in order to improve the quality of care in the department.

It is completely reasonable for leadership to expect obstetrical physicians and nurses to be up to date in their clinical knowledge. In fact, all practitioners have an obligation to remain current and knowledgeable in their fields. Moreover, state licensing boards mandate this by imposing continuing education requirements; therefore, hospitals have not only the right, but the duty, to insist that their practitioners fulfill these requirements. In terms of financial cost, preventing one medical malpractice suit will more than make up for the cost of providing educational resources for the medical staff.

The following are some specific examples of ways to encourage/convince obstetricians, midwives, and L&D nurses to participate in educational programs:

  • Mandate and document completion of a certain number of hours of education each year as a condition of reappointment to the medical staff; e.g., reading medical journals, attending conferences, taking online courses.
  • Make it easy for them to participate in continuing medical education; e.g., provide teaching conferences on campus; give them access to journals and online courses.
  • Offer financial incentives and time off to attend educational programs and conferences.
  • Work with liability insurers to provide a discount for taking part in educational programs or institute a surcharge for nonparticipation.

2. Fetal Heart Monitor Interpretation Re-Education

This specific but vital subset of clinician education is a must for any clinical improvement program in obstetrics.

Because fetal heart rate (FHR) monitoring is so widely and frequently used, there is a general sense among obstetricians, midwives, and obstetrical nurses that they know how to use this tool and need no further training on it. However, multiple studies have shown that there is tremendous variation in the ability of providers to correctly interpret FHR tracings. Often, the nomenclature used to describe features of the strips is inconsistent and therefore subject to misinterpretation.

Re-education and ongoing skill improvement for FHR monitor interpretation is vitally important. Not only do fetal heart monitor education courses reinforce evidence-based interpretation of FHR patterns, but they also teach the standard NICHD nomenclature that is recommended by all official obstetrical organizations.

There are many options available for this education:

  • Obstetricians or nurses can lead small group sessions on their L&D units at any time merely by discussing strips of current patients visible on the monitors in front of them.
  • Leadership can hold formal teaching sessions on a weekly or monthly basis in the department.
  • There are excellent online courses both for comprehensive FHR monitoring instruction and for shorter exercises involving clinical scenarios and FHR interpretation.

3. Simulation Training and Drills

Fortunately, the majority of obstetric patient care episodes are routine; but the fact remains that unpredictable and unexpected life-threatening emergencies do occur, and they are potentially devastating for everyone involved - patients, family and staff. Events such as shoulder dystocia, cord prolapse, amniotic fluid embolism, pulmonary embolism, and abruptio placenta require almost instantaneous recognition and implementation of an exactingly precise protocol to provide the best chance of an optimal outcome for mother and baby.

The paradox here is obvious: these emergencies require finely honed skills to treat them, but because they occur so rarely, it is difficult for practitioners to develop the expertise necessary to treat them. That’s where simulation programs and drills come in. It is only by practicing the management of such acute emergencies frequently that a practitioner’s skills will be sharp when the real emergency actually occurs. Published data demonstrates that units that practice obstetrical emergency drills on a regular basis have improved outcomes for both mothers and babies.

Simulation programs and drills have been developed in many formats across the United States. Most are excellent; but some have significant drawbacks. A common model is for an institution or group of institutions to develop a high-tech simulation center with lifelike models and the ability to simulate multiple clinical situations.

  • The benefits of such programs are obvious: they are realistic; they provide an opportunity to practice rarely used skills; and they take place in a specially designed teaching environment.
  • However, these programs also have their downsides: they usually require physicians and nurses to travel to an off-site simulation center, taking extra time away from their clinical activities and resulting in training with people other than those with whom they will be working during real emergencies; and the simulation centers, however well-designed, are not the same as the L&D units in the facilities where practitioners will actually encounter emergencies.

There is another, more low-tech way to do simulation training that can be led by a physician or nurse facilitator on one's own L&D unit. He or she presents a simple clinical scenario, after which small groups of nurses and doctors run through how they would manage the described clinical situation. After each run through of the scenario, there is a group discussion of what went well and what did not go well. The facilitator also uses this time to go over a set of predetermined teaching points that are appropriate for the particular emergency drill.

Such drills can use either a simple pelvic model, a volunteer lying in a bed, or even an imaginary patient. The key is to walk through the steps of how specific emergencies should be handled multiple times so that the steps are fresh in the minds of physicians and nurses when a real emergency occurs.

There are specific techniques that must be practiced during simulation training for shoulder dystocia. However, these can be practiced just as easily with a simple doll or rubber pelvis as with a $50,000 high-tech model.

During simulation training, it is important to incorporate teamwork and communication into the interactions between the clinicians caring for the patient. The patient safety literature clearly documents how important it is for teams to practice working together, for clear and simple language to be exchanged and verified, and for specific clarifying communication techniques to be employed in order to maximize team performance during obstetrical emergencies. Such teamwork and communication skills training can easily be incorporated into both high-tech and low-tech drills and are a vital component of the safety benefits of such programs.

Remember that low-tech simulation training works just as well as high-tech. The most important aspect of simulation programs, drills, and team training is not the complexity of the equipment, but the frequency of repetition of the steps that need to be taken when such emergencies occur and practicing of skills that will help a team work together smoothly and efficiently.

4. Feedback

It is not enough for physicians and nurses to merely go through the motions of participating in educational programs. They must assimilate the knowledge from such programs, use the skills introduced to improve their performance, demonstrate teamwork, and employ effective communication techniques in practice. In order to accomplish this, they must receive regular feedback on their performance in a variety of clinical and interpersonal areas.

Feedback can take many forms.

  • For physicians, it can simply be a discussion with the department chief as to their performance on a set of quality metrics. For most physicians, all it takes is being aware that they are an outlier in one or more areas compared to their peers for them to question their own clinical behavior and make appropriate changes. The same is true of documentation. Feedback as to the completeness of prenatal documentation and the appropriateness and timeliness of labor and delivery notes (especially in an emergency situation such as shoulder dystocia) gives important information to clinicians about the quality of obstetrics they are practicing and can serve as the catalyst for change.
  • Nurses usually have an ongoing performance review through their nurse managers. Such reviews can include participation in educational programs and competency in teamwork skills and communication.

Conclusion

Outcomes in obstetrics will never be 100% ideal; the biology of the birthing process is simply not amenable to that. But all L&D units can and should strive to provide the best possible care for all their laboring patients. Any L&D unit with the necessary personnel, equipment, and training should approach peak performance and outcomes.

Education, evaluation, and simulation/team training must be ongoing programs that are frequently repeated, and they need to be modified as new knowledge and information become available.


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Websites: www.henrylerner.com
   http://shoulderdystociainfo.com
Follow this topic: RSQ_OB
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Featured Courses:

  • Neonatal Emergencies – in development
  • Postpartum Hemorrhage
  • Neonatal Asphyxia
  • Ectopic Pregnancy in Obstetrics & Gynecology
  • Pitfalls & Liability Risks in Labor – in development
  • Pitfalls & Liability Risks in Prenatal Care – in development
  • Shoulder Dystocia
  • Anatomy of a Medical Negligence Lawsuit in Obstetrics & Gynecology
The Sullivan Group is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Some continuing education activities were approved by the Emergency Nurses Association, an accredited approver of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.


The details of the CME and/or CE for all TSG activities can be found here.


Copyright © 1998 - 2013, The Sullivan Group, All Rights Reserved. These materials comprise the proprietary information of The Sullivan Group. Unauthorized use, copying or dissemination of these materials is strictly prohibited. U.S. Patent No. 7,197,492
Contact us

 

Brant Roth
Director of Business Development

Toll free: 1-855-RSQ-INFO (777-4636) 
Phone: 1-630-268-1188  

broth@thesullivangroup.com


Karen Ragland
Account Executive

Toll free: 1-855-RSQ-INFO (777-4636) 
Phone: 1-303-652-3311 

kragland@thesullivangroup.com


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