Development of the TeamOBS-PPH - targeting clinical performance in postpartum hemorrhage

作者：Brogaard Lise^*; Hvidman Lone; Hinshaw Kim; Kierkegaard Ole; Manser Tanja; Musaeus Peter; Arafeh Julie; Daniels Kay I; Judy Amy E; Uldbjerg Niels

来源：Acta Obstetricia et Gynecologica Scandinavica, 2018, 97(6): 677-687.

DOI：10.1111/aogs.13336

• Postpartum hemorrhage
• health teams
• interdisciplinary
• validation studies
• emergency teams
• checklist
• evaluation research
• emergency care
• hospital rapid response team

IntroductionThis study aimed to develop a valid and reliable TeamOBS-PPH tool for assessing clinical performance in the management of postpartum hemorrhage (PPH). The tool was evaluated using video-recordings of teams managing PPH in both real-life and simulated settings.
Material and methodsA Delphi panel consisting of 12 obstetricians from the UK, Norway, Sweden, Iceland, and Denmark achieved consensus on (i) the elements to include in the assessment tool, (ii) the weighting of each element, and (iii) the final tool. The validity and reliability were evaluated according to Cook and Beckman. (Level 1) Four raters scored four video-recordings of in situ simulations of PPH. (Level 2) Two raters scored 85 video-recordings of real-life teams managing patients with PPH 1000 mL in two Danish hospitals. (Level 3) Two raters scored 15 video-recordings of in situ simulations of PPH from a US hospital.
ResultsThe tool was designed with scores from 0 to 100. (Level 1) Teams of novices had a median score of 54 (95% CI 48-60), whereas experienced teams had a median score of 75 (95% CI 71-79; p < 0.001). (Level 2) The intra-rater [intra-class correlation (ICC) = 0.96] and inter-rater (ICC = 0.83) agreements for real-life PPH were strong. The tool was applicable in all cases: atony, retained placenta, and lacerations. (Level 3) The tool was easily adapted to in situ simulation settings in the USA (ICC = 0.86).
ConclusionThe TeamOBS-PPH tool appears to be valid and reliable for assessing clinical performance in real-life and simulated settings. The tool will be shared as the free TeamOBS App.

• 出版日期2018-6