Multi-professional training for obstetric emergencies in a US hospital over a 7-year interval: An observational study

Abstract

Objective:Birth is less safe than it can be. We adapted the UK-developed PROMPT™ (PRactical Obstetric Multi-Professional Training) course to local practices and initiated annual training.Study Design:This observational study used quality assurance data from University of Kansas Hospital 2 years before and 7 years after intervention encompassing 14 309 consecutive deliveries from January 2006 through December 2014. An events/trials approach was applied to changes in proportions over time.Result:PROMPT™ was associated with progressive decreases in rates (P<0.05) of brachial plexus injury and umbilical artery pH <7.00 exclusive of catastrophic events. Reduced rates (P<0.05) of cesarean section, episiotomy and higher perception of nurse/physician communication were documented. Hypoxic ischemic encephalopathy (HIE) rates declined progressively by >50% (P=NS). These improvements occurred despite younger faculty and higher rates of complicated pregnancies (P<0.05). Estimated health-care costs avoided exceeded annual training costs.Conclusion:Local annual multi-professional training as provided by PROMPT™ was temporally associated with improved obstetric outcomes.