Using Hourly Time-Outs and a Standardized Tool to Promote Team Communication, Medical Record Documentation, and Patient Satisfaction During Second-Stage Labor.


Journal Article

BACKGROUND:During labor, effective communication and collaboration among the healthcare team is critical for patient safety; however, there is currently no standard for communication and documentation of the plan of care as agreed upon by healthcare team members and the woman in labor. OBJECTIVES:The goal of this project was to increase consistency in communication and collaboration between clinicians and laboring women during second-stage labor. METHODS:An hourly "time-out" meeting of all healthcare team members was initiated for all women during second-stage labor. A documentation tool was implemented to ensure regular and clear communication between the clinical team and laboring women. Data were collected via medical review of cases of second-stage labor lasting more than 2 hours (n = 21 in the pre-implementation group; n = 39 for 3 months postimplementation; and n = 468 patients for 2 years post-implementation). Surveys were conducted of the clinical team (n = 40) and patients (n = 28). RESULTS:Following implementation, documented agreement of the plan of care increased from 14.3% before the project to 82.1% 3 months after implementation and remained at 81.6% 2 years after implementation. All nurses who participated in the survey reported a clear understanding of how and when to complete necessary medical record documentation during second-stage labor. The providers viewed the project favorably. Most women (92.9%) reported satisfaction with their experience. This project enhanced collaborative communication between members of the clinical team and laboring women and improved patient satisfaction. The improvements were sustainable over a 2-year period.

Full Text

Duke Authors

Cited Authors

  • Wood, J; Stevenson, E

Published Date

  • July 2018

Published In

Volume / Issue

  • 43 / 4

Start / End Page

  • 195 - 200

PubMed ID

  • 29652678

Pubmed Central ID

  • 29652678

Electronic International Standard Serial Number (EISSN)

  • 1539-0683

International Standard Serial Number (ISSN)

  • 0361-929X

Digital Object Identifier (DOI)

  • 10.1097/nmc.0000000000000442


  • eng