Table 2 Example of a display of the changes that occurred over time
Summary of working group improvement efforts by phase of implementation
PhaseDate completeInterventions by working groups
Birthing centre nursesProvidersAnaesthesiaOperating room
1Summer 2002
  • Analysed tasks

  • Established dedicated CD phone line

  • Created OB anaesthesia questionnaire

  • Purchased dedicated OR infant “stabilet”

  • Reassigned inappropriate tasks

  • Programmed on-call team members into computer

  • Placed completed questionnaire on birthing centre

  • Prepare OR for “STAT” CD each evening

  • Eliminated unnecessary tasks (eg, transfer of patient to stretcher)

  • Programmed birthing centre phones with CD line on speed dial

  • Developed process for antenatal anaesthesia consults

  • Trained birthing centre nurses to check “stabilet” and OR preparedness each evening

  • Organised supplies into CD kits

  • Instituted mightly test of system with mandatory call back requirement

  • Review OB high risk and VBAC lists each week

2Spring 2003
  • Replaced OR checklist with CD specific checklist

  • Designated codes to indicate “STAT” v routine CD

  • Recommend CBC, type and screen on all labouring women

  • Used mock CDs to identify steps in routine process that could be eliminated during emergency

  • Developed standardised terminology

  • Worked with providers to develop standardised terminology

  • Synchronised OR clocks with birthing centre clocks

  • Distributed flow charts of “STAT” process

  • Created standardised brief operative note

  • Assisted with development of “STAT” process map

  • Assisted with development of “STAT” process map

  • Finalised “STAT” process map

  • Assisted with development of “STAT” process map

3Spring 2004
  • Participated in OR skills day and “STAT” pathway mock drills

  • Participated in OR “skills day” and “STAT” pathway mock drills

  • Participated in OR “skills day” and “STAT” pathway mock drills

  • Participated in OR “skills day” and “STAT” pathway mock drills

  • Empowered nurses and CNMs to transport patients to OR in emergency

  • Trained nurses in anaesthesia set up

  • Trained nurses in OR set up

  • CD, caesarean delivery; OR, operating room; VBAC, vaginal birth after previous caesarean section.