Crisis Teams for Obstetric Patients

Inpatient obstetric care involves periodic maternal and/or fetal crisis situations. During events such as fetal bradycardia, shoulder dystocia, anaphylaxis, and maternal hemorrhage, patient care needs to greatly exceed the resources allocated to routine care. As a result, many institutions established obstetric-specific crisis teams as local quality improvement initiatives. Event review of rapid response team (RRT) episodes in an obstetric setting suggests that the medical RRT composition was not ideal for obstetric patients. Many of the patients needed to go to the delivery room emergently and that requires skills, equipment, and tasks that are not usually required in a medical rapid response. Key personnel not included on the medical RRT include obstetricians, obstetric nurses, newborn resuscitation team, anesthesia providers, and transport personnel. Thus, an obstetric RRT is required. In this chapter, the need for a specialized obstetric crisis response team will be explored. In addition, the team composition, triggering criteria, implementation hints, and linkage to quality improvement and patient safety efforts in the hospital will be discussed.