Team working and transitions in maternity care

Safe maternity care depends on the work of effective, well trained and capable multi-professional teams.

Maternity teams commonly include midwives, maternity care assistants, obstetricians, anaesthetists and junior doctors, and can draw on and interact with a much wider and diverse range of professionals across the healthcare system. Ensuring that all of these professionals understand their roles, communicate clearly, handover tasks and information effectively and work together constructively is essential to maintain patient safety in maternity care.

Team working is a skill that can be trained and supported through different educational approaches. There are a range of tools and courses that can be used to develop effective team work skills across maternity care. These include multi-professional simulation training, assessment questionnaires, coaching and mentorship, and formal courses. An important aspect in all of these approaches is ensuring that professionals gain a clear understanding of their own roles in relation to the roles of others, and are immersed in the experience of working productively together across professional boundaries

One of the most challenging aspect of team work in maternity involves the various forms of clinical handover that can take place at different stages of maternity care. Designing effective handover techniques is a core concern in many areas of patient safety, and has been examined in detail specifically in relation to maternity care.  There are a variety of established tools and tactics that can be used to ensure safe transitions of care. Training on many of these handover techniques helps to build broader teamwork and communication skills.

One particular approach to managing transitions and clinical handovers is often the ‘SBAR’ technique. This has been successfully employed in a wide range of maternity settings. Using the recipe, ‘Situation - Background - Assessment - Recommendation’ provides a clear and structured form to communication that can help aid concise and accurate communication during handovers in maternity care. A range of other techniques include briefings and de-briefings before and after key events, and embedding routine daily briefings into maternity care to support collective awareness of safety issues.

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