Who is leading maternity teams? An observational study of leadership sharing in maternity teams and the relationship to teamwork performance.

• Register: ANZCTR
• Last refreshed on: 12 July 2021
• Main ID: ACTRN12618000223235
• Date of registration: 12/02/2018
• Prospective Registration: No
• Primary sponsor: Mater Health
• Public title: Who is leading maternity teams? An observational study of leadership sharing in maternity teams and the relationship to teamwork performance.
• Scientific title: Who is leading maternity teams? An observational study of leadership sharing and teamwork performance.
• Date of first enrolment: 09/09/2016
• Target sample size: 14
• Recruitment status: Completed
• URL: https://anzctr.org.au/ACTRN12618000223235.aspx
• Study type: Observational
• Study design: Purpose: Psychosocial;Duration: Cross-sectional;Selection: Defined population;Timing: Retrospective;
• Phase: Not Applicable

Countries of recruitment

Australia

Contacts

• Name: Dr Sarah Janssens

• Name: Dr Sarah Janssens

Key inclusion & exclusion criteria

Inclusion criteria: Participants at the "Maternity Emergency Management" (MEM) course at Mater Education. Includes Doctors, Midwives and midwifery students.
Exclusion criteria: Groups of participants in which any team member has not consented to participate or have video storage.

Age minimum: 18 Years
Age maximum: No limit
Gender: Both males and females

Health Condition(s) or Problem(s) studied

Leadership within Maternity Emergency Teams ;Teamwork within Maternity Emergency Teams. ;
Leadership within Maternity Emergency Teams

Teamwork within Maternity Emergency Teams.

Reproductive Health and Childbirth - Childbirth and postnatal care

Public Health - Health service research

Intervention(s)

Multidisciplinary teams participating in immersive simulation scenarios of obstetric emergencies will be viewed retrospectively by trained raters. Simulation scenarios are delivered within an 8 hour simulation course. Participants undergo an introductory session including a 45 minute interactive teaching session on principles of crisis resource management. Scenarios last 10-15 minutes and are followed by a 20-40 minute debrief conducted by a trained facilitator. Participants participate in or observe 6 simulated scenarios during the course. Active participation in the 2-4 scenarios occurs for each participant. Scenarios include maternal collapse ( 2 cases), uterine inversion, post partum haemorrhage, eclampsia and shoulder dystocia

Primary Outcome(s)

Teamwork score - Auckland Team Behaviour Score [Scoring is per scenario, scored retrospectively via analysis of video data. Each team is scored independently. Team composition is not stable ( as it isn't in real life) so no in tact team is scored twice however, individuals may be present in different teams. ]

Clinical teamwork scale[Scoring is per scenario, scored retrospectively via analysis of video data. Each team is scored independently. Team composition is not stable ( as it isn't in real life) so no in tact team is scored twice however, individuals may be present in different teams. ]

Secondary Outcome(s)

checklist of clinical performance measures as a composite outcome.
Developed for this study following review of national and international guidelines for management and refined by a panel of subject matter experts.

Retained placenta scenario:
Apply oxygen
Commence BP, HR and sats monitoring
Commence IV Fluid bolus
Insert second IV line
Send bloods – FBC, Coag G&S or X match
Administer IM oxytocin
Administer IM ergometrine
Commence IV oxytocin
Insert IDC
Perform uterine tone assessment and massage
Examine lower genital tract for trauma
Examine placenta
Decision to go to theatre (Time___________)

Uterine inversion scenario
Apply oxygen
Commence BP, HR and sats monitoring
Commence IV Fluid bolus
Insert second IV line
Send bloods – FBC, Coag G&S or X match
Does not administer oxytocics prior to replacement
Does not perform further traction on cord
Assesses fundus
Perform vaginal examination
Replace uterus manually (Time_________)
Continues manual replacement until uterine contraction confirmed
Commence oxytocin infusion one uterus replaced
Decision to go to theatre
[Scoring is per scenario, scored retrospectively via analysis of video data. Each team is scored independently. Team composition is not stable ( as it isn't in real life) so no in tact team is scored twice however, individuals may be present in different teams. ]

Time to critical management (measured in minutes and seconds)
- measured as time from declaration of the emergency to institution of critical management:
- uterine inversion scenarios this is defined as replacement of the uterus (only for uterine inversion scenario)
- PPH secondary to retained placenta this is defined as the time that the decision is made to transfer to the operating room for surgical treatment. (only for retained placenta scenario)

These time point have been decided on by a panel of subject matter experts and designed specifically for this study. Other simulation studies have used similar "time to implement" critical management measures specific to the simulation scenario.

[Scoring is per scenario, scored retrospectively via analysis of video data. Each team is scored independently. Team composition is not stable ( as it isn't in real life) so no in tact team is scored twice however, individuals may be present in different teams. ]

Secondary ID(s)

N/A

Source(s) of Monetary Support

Mater Foundation

Secondary Sponsor(s)

Monash University

Ethics review

Status: Approved
Approval date: 18/03/2016
Contact:

MML HREC

Results

• Results available: Yes
• Date Posted: 06/07/2021
• Date Completed: 30/04/2018