Literature DB >> 31013540

Understanding the Heterogeneity of Labor and Delivery Units: Using Design Thinking Methodology to Assess Environmental Factors that Contribute to Safety in Childbirth.

Jules P Sherman1, Laura C Hedli2, Alexandria I Kristensen-Cabrera2, Steven S Lipman3, Doug Schwandt2, Henry C Lee2, Lillian Sie2, Louis P Halamek2, Naola S Austin3.   

Abstract

OBJECTIVE: There is limited research exploring the relationship between design and patient safety outcomes, especially in maternal and neonatal care. We employed design thinking methodology to understand how the design of labor and delivery units impacts safety and identified spaces and systems where improvements are needed. STUDY
DESIGN: Site visits were conducted at 10 labor and delivery units in California. A multidisciplinary team collected data through observations, measurements, and clinician interviews. In parallel, research was conducted regarding current standards and codes for building new hospitals.
RESULTS: Designs of labor and delivery units are heterogeneous, lacking in consistency regarding environmental factors that may impact safety and outcomes. Building codes do not take into consideration workflow, human factors, and patient and clinician experience. Attitude of hospital staff may contribute to improving safety through design. Three areas in need of improvement and actionable through design emerged: (1) blood availability for hemorrhage management, (2) appropriate space for neonatal resuscitation, and (3) restocking and organization methods of equipment and supplies.
CONCLUSION: Design thinking could be implemented at various stages of health care facility building projects and during retrofits of existing units. Through this approach, we may be able to improve hospital systems and environmental factors. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Entities:  

Mesh:

Year:  2019        PMID: 31013540      PMCID: PMC6989398          DOI: 10.1055/s-0039-1685494

Source DB:  PubMed          Journal:  Am J Perinatol        ISSN: 0735-1631            Impact factor:   1.862


  11 in total

1.  Human error: models and management.

Authors:  J Reason
Journal:  BMJ       Date:  2000-03-18

2.  Medscape's response to the Institute of Medicine Report: Crossing the quality chasm: a new health system for the 21st century.

Authors:  M Leavitt
Journal:  MedGenMed       Date:  2001-03-05

3.  The "To Err is Human" report and the patient safety literature.

Authors:  H T Stelfox; S Palmisani; C Scurlock; E J Orav; D W Bates
Journal:  Qual Saf Health Care       Date:  2006-06

Review 4.  The delivery room of the future: the fetal and neonatal resuscitation and transition suite.

Authors:  Neil N Finer; Wade Rich; Louis P Halamek; Tina A Leone
Journal:  Clin Perinatol       Date:  2012-12       Impact factor: 3.430

5.  Medical error-the third leading cause of death in the US.

Authors:  Martin A Makary; Michael Daniel
Journal:  BMJ       Date:  2016-05-03

Review 6.  Building Comprehensive Strategies for Obstetric Safety: Simulation Drills and Communication.

Authors:  Naola Austin; Sara Goldhaber-Fiebert; Kay Daniels; Julie Arafeh; Veronique Grenon; Dana Welle; Steven Lipman
Journal:  Anesth Analg       Date:  2016-11       Impact factor: 5.108

7.  Levels of maternal care.

Authors:  M Kathryn Menard; Sarah Kilpatrick; George Saade; Lisa M Hollier; Gerald F Joseph; Wanda Barfield; William Callaghan; John Jennings; Jeanne Conry
Journal:  Am J Obstet Gynecol       Date:  2015-01-22       Impact factor: 8.661

8.  A survey of delivery room resuscitation practices in the United States.

Authors:  Tina A Leone; Wade Rich; Neil N Finer
Journal:  Pediatrics       Date:  2006-02       Impact factor: 7.124

9.  Thematic Analysis of Women's Perspectives on the Meaning of Safety During Hospital-Based Birth.

Authors:  Audrey Lyndon; Jennifer Malana; Laura C Hedli; Jules Sherman; Henry C Lee
Journal:  J Obstet Gynecol Neonatal Nurs       Date:  2018-03-16

10.  Analyzing the heterogeneity of labor and delivery units: A quantitative analysis of space and design.

Authors:  Naola Austin; Alexandria Kristensen-Cabrera; Jules Sherman; Doug Schwandt; Allison McDonald; Laura Hedli; Lillian Sie; Steven Lipman; Kay Daniels; Lou P Halamek; Henry C Lee
Journal:  PLoS One       Date:  2018-12-26       Impact factor: 3.240

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