- focuses on the association between teamwork and clinical performance in emergency obstetrical situations
In Denmark, midwifes are responsible for most deliveries without help from doctors or other professionals. If a complication occurs, however, obstetricians, pediatricians etc. must participate in an interdisciplinary team with the midwife.
Research has shown that imperfect communication and corroboration in these interdisciplinary teams is a crucial cause of undesirable treatment.
Therefore, over the past several years we have regularly trained our staff to interact in interdisciplinary teams. This has been done during exercises with simulated complicated deliveries. These simulations have been videotaped and analyzed. This has already created a much better understanding of the obstetrical teamwork needed in emergency situations.
In the research project TeamOBS, we want to video record real deliveries to get an even better understanding and knowledge of the association between the communication and cooperation and the quality of the performance of the interdisciplinary team. This is expected to result in fewer undesirable treatments and fewer mistakes, thus increasing quality and safety in the treatment of mother and child.
The video recording is activated by a chip in the obstetrician´s telephone when she enters the delivery room. The videotaping focuses on the cooperation within the team and not on the patient. Oral and written consent is required from all persons in the videotape before usage in the project, i.e. the patient, the relatives, and the staff members. If any of these persons does give consent, the video recording will be discharged.
The videotaping will take place at the Regional Hospital Horsens and Aarhus University Hospital. It does not include personal information such as civil registration numbers, hospital records, etc.
The videotapes are used to research anonymously and are only shown to six selected research qualified persons. In other words, the research is only based on the videotapes and not on personal data – neither for the patient or the staff. Therefore, it is not possible to use the videotapes for private interests.
It is important to emphasize that videotaping of all normal deliveries will NOT occur. Thus, most deliveries will not be videotaped and not be used in the project.
1. To study and describe the cooperation in the interdisciplinary teams during complicated deliveries. The view is to identify factors that are crucial for the optimal treatment of mother and child.
2. To develop scoring tools to evaluate the cooperation in the interdisciplinary teams.
The project began at the Regional Hospital Horsens in the fall of 2014 and at Aarhus University Hospital in the spring of 2015. We expect the last participants to be recruited by April 2017.
The results will be available on our website in the fall of 2017.
Are you pregnant and scheduled to give birth at Regional Hospital Horsens or AUH, Skejby, during your pregnancy, you will receive written information about the TeamOBS project. The majority of all deliveries are normal; thus, most women will not be included in the project.
YOU CAN PARTICIPATE IN THE PROJECT IF:
- After arrival to the hospital and during delivery, you suddenly need help that requires assistance from an emergency team.
- All persons in the videotaping give oral and written consent that the videotaping can be used in the project.
YOU CAN NOT PARTICIPATE IN THE PROJECT IF YOU:
- or someone in the videotape does not give oral and written consent.
- or someone in the videotape later withdraw their consent.
Frequently asked questions
I have not received the information brochure
It is possible to find the brochure under “documents and certificates”
What does the project mean to me?
For most pregnant women it will not mean anything. Only about 5-10 % of all deliveries experience emergency situations where the videotaping will occur. If this happens, you will be asked for written and oral consent so that the videotaping can be used in the project.
I would like to participate in the project. What should I do?
Only a small percentage of pregnant women who experience an emergency during delivery can participate in the project. In that case, the staff in the delivery room will ask you if you would like to participate.
I do not want to participate in the project. What should I do?
No videotaping will occur during normal deliveries. That is, most deliveries will not be videotaped; thus, most pregnant women will not be asked to participate in the project. If you experience an emergency situation during your delivery, you will be asked for written and oral consent. If you do not want to participate, the videotape will be destroyed without anyone seeing it.
What happens if I participate in the project?
If you give consent to participate in the project, the videotaping will be saved. The videotape will be anonymized, i.e. no personal data or information about the persons involved in the videotape will be available. The videotape will be analyzed by educated doctors and midwifes. Afterwards, it will be destroyed. All data are subject to the Danish Act on Processing of Personal Data with a view to the protection of the involved persons.
How and how long is the videotape stored?
When a videotape is included in the project, it will be stored according to the guidelines of The Danish Data Protection Agency. Data will be stored anonymously until the end of the project in the fall of 2017.
Can I see the videotape?
No. The videotape cannot be released to other people. Only the research team can see it.
If I accept to participate in the project, can I change my decision?
Yes, your consent can be withdrawn according to the health legislation § 43, section 1. It can be withdrawn until one year after the given date.
- If you can’t find answers to your questions on this website, you are welcome to contact us under “contact”
If you are a staff at Regional Hospital Horsens and AUH, Skejby, before the project starts, you will receive oral and written information about the project.
YOU CAN PARTICIPATE IF YOU:
- Are on an emergency team at the maternity ward.
- And all persons in the videotape give oral and written consent that the videotape can be included in the project.
Documents and certificates
In the following, you can find documents and certificates that are used in the project
This project is approved by the Danish Data Protection Agency and the legal department in Central Denmark Region. Furthermore, Central Denmark Region approves the project under the joint umbrella review of research projects.
Frequently asked questions
Which emergency situations are included in the project?
All emergency deliveries which require a doctor’s care can be included. At the top of the consent form, you can tick off the specific situation that caused the emergency. However, if a doctor is called for a simple consultation (for instance, to assist in estimating laceration or CTG) the delivery will not be included in the project.
Can I say no to participation in the project?
Yes, you can indicate that you do not want to participate. In that case, all videotapes with you will be destroyed without anyone seeing it.
Who is going to see the videotape?
6 persons who are educated in analyzing videos.
Where can I find my statement of consent?
They are placed on the wall in the delivery room. Signed consents should be put in the mailbox with the name ”Project TeamObs”. If you cannot find the consents, it can be printed from the website under ”documents and certificates”.
Who is collecting the consent?
The midwife or midwife supervisor will collect the consent from all delivery rooms.
How and how long is the videotape kept?
When the videotape is included in the project, it will be stored according to the guidelines of the Danish Data Protection Agency. All data will be stored anonymously until the end of the project in the fall of 2017.
If I agree to participate in the project, can I change my decision?
Yes. Consent to the project is given according the Danish Act on Processing of Personal Data (§7). It can be withdrawn at any time.
Can I see the videotape?
No. The videotape cannot be released to anyone except the research group.
What if I have not received the information brochure?
It is possible to find the brochure under ”documents and certificates” (Danish). If you can’t find answers to your questions on this website, you are welcome to contact us under “contact information”.
Live team nr. 100 videotaped
The project now includes the first 100 videotapes with help from the amazing staff at the maternity ward at AUH and at the Regional Hospital Horsens. We would also like to thank all the pregnant women who have agreed to participate in the project.
“Trygfonden” donates 430,000 € to the project
We are happy to announce that “Trygfonden” has decided to support our project with 430,000 €. The donation is crucial to optimize the research and the benefits of the project.
Live team nr. 50 videotaped
The project now includes the first 50 videotapes with help from the amazing staff at the maternity ward at AUH and at the Regional Hospital Horsens.
We are now videotaping at Skejby
Today, we start the project at Aarhus University Hospital.
12 delivery rooms are monitored with three cameras that videotape the staff when an emergency occurs. If all persons in the videotape give consent, the videotape can be included in the project.
Donation for 40,000 €
The Foundation “Rådgivningsgruppen for Færdigheds- og Simulationstræning i Videreuddannelsesregion Nord” donated 40,000 € to the project. The money is earmarked for video analysis and is crucial for the output of the videotaping.
There was a piece on the local news in the southern part of Jutland about the project.
There was a piece on the local news in the eastern part of Jutland about the project.
First live team is videotaped
The first real deliveries are videotaped at the Regional Hospital Horsens. It happened on the first day of the project.
Web-based news media
The project is mentioned in several forms of the Danish news media.
We are ready to videotape real deliveries
The first hospital is now ready for videotaping of real deliveries. On October 20th, we will start including videotapes of real deliveries at the maternity ward in Horsens. Each videotape is recorded automatically when a doctor arrives at the delivery room. It is only saved and used if everyone in the videotape gives consent. The videotape is destroyed after analysis and cannot be shown to anyone other than the research team.
The videotapes are a unique opportunity to get a better knowledge of our skills and how we can get better.
In situ simulation Skejby
Training of the teams was conducted at Skejby for six days in August and September. The doctors, midwifes and assistants participated in the scenarios involving post partum hemorrhage and shoulder dystocia.
The scenarios were recorded with consent from the persons involved and we have now included 74 teams in study two.
Patient information is handed out
We have begun handing out brochures for pregnant women who are scheduled to deliver at Horsens or Skejby. These women need to know that the delivery will be videotaped if an emergency occurs. The aim of the project is to make the staff even better at handling emergency situations during delivery. Today, we will hand out brochures about the project in Horsens at ultrasound in gestation week 19 and at the midwife consultation in gestation week 35. In Skejby, we will start handing out brochures in October. If you’d like to see the brochure, you can find it on our website under ”Documents and certificates”.
In situ simulation Horsens
There has been training of the teams at HEH.
Read further below
05/27/2014 and 06/04/2014 Midwifes, obstetricians, anesthesiologist, and nurse anesthetists participated in simulation scenarios, perimortem section, and shoulder dystocia. We videotaped the scenarios after consents from all involved persons.
The project was spoken about on the radio
An article was written about the project
Please do not hesitate to contact us by email if you have any questions:
- Rådgivningsgruppen for Færdigheds- og Simulationstræning i Videreuddannelsesregion Nord
- Kvindeafdelingen, Hospitalsenheden Horsens
- Forskningsenheden, Hospitalsenheden Horsens
- Klinisk Institut, Aarhus Universitets Hospital, Skejby
- Region Midt, fondsmidler afsat til tværfaglig efteruddannelse
Phd student, MD, Dept. Obstetrics and Gynaecology, Horsens Regional
Main Supervisor, Professor, Dept. Obstetrics and Gynaecology, Aarhus University Hospital, Skejby
Assistant Supervisors, Associate Professor, PhD Aarhus University, Centre for Medical Education, INCUBA Science Park-Skejby
Assistant Supervisors, Consultant, PhD, Dept. Obstetrics and Gynaecology, Aarhus University Hospital
Assistant Supervisors, Professor PD Dr., Director, University of Bonn, Institute of Patient Safety.
Assistant Supervisors, Professor M.D. Program Director, San Diego & Visiting Professor Aarhus University
Clinical Supervisor, Consultant, Dept. Obstetrics and Gynaecology, Horsens Regional Hospital, Clinical Supervisor