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Safety Self-Assessment

To begin, each site must evaluate the foundation upon which safety improvements will be made. Answer the following questions. Gather documents in a central location in preparation for working on strategies.

  • Do you have a document explaining how obstetrical clinical guidelines are developed, implemented and revised?
    • Do you have a committee or an individual charged with this task?
    • How do you monitor for and respond to changes in standard of care?
  • What is your obstetrical QA process?
    • How do you share obstetrical outcomes with staff?
    • Do you have a written description of how this works?
    • What are your OB/GYN indicators?
    • What regular QA/QI meetings do you have?
      • What is the schedule?
      • Who leads/attends the meetings?
  • How do you conduct credentialing and privileging in Obstetrics? Reappointments?
    • Do these processes apply to all physicians and midwives?
      • Who is accountable for this process?
  • How do you orient new nurses in obstetrics?
    • What annual education and training do you require for nurses?
  • What do you have in place regarding the chain of communication (previously called chain of command)?
  • Do you have statements or guidelines regarding consultation, referral or transfer of care?
  • Provide your documentation templates.
  • Provide clinical guidelines or other documents which address:
    • EFM and fetal heart auscultation
    • induction and augmentation of labor
    • terms to convey urgency regarding cesarean section
    • diagnosis/management of hypertensive disorders of pregnancy
    • post-EDD management
    • GBS screening and prophylaxis
    • DVT prevention
    • antibiotic prophylaxis
    • access to prenatal records at intrapartum site
  • Describe drills you currently conduct or require.
  • Are there any other documents in place that address obstetrical care at your site?