Project description

Background

In Denmark, midwifes are responsible for most deliveries without help from doctors or other professionals. If a complication occurs, however, more midwifes, obstetricians and assistances must participate in an interdisciplinary team.

Working in emergency teams can be a challenge as the team composition varies each time. Successful management of emergency obstetrics requires a rapid and coordinated response from the team. A prerequisite for this is that the individuals are well trained. 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. In addition to this, debriefing is a recognized method to maintain and improve team performance. Research show that debriefings using video recordings to review own performance, can improve emergency teams’ management of critical situations. Video debriefing is used in several emergency specialties but has not been used in the delivery ward.

In the research project TEAM OBS Debriefing, we want to video record real deliveries if a postpartum hemorrhage occurs and use these video recordings in team debriefings. Knowledge from this project is important to maintain and improve clinical skills in the delivery ward.

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Project implementation

The video recording is activated by a chip in the obstetrician´s telephone when she enters the delivery room. The video recording focuses on the cooperation within the team and not on the patient. Oral and written consent is required from all persons in the video recording before the video recording can be used in the project. Video recording will take place at the Regional Hospital Horsens and Aarhus University Hospital Skejby.

The project does not include personal information such as civil registration numbers, hospital records, etc.

The video recording will be anonymized and will be used in a subsequent debriefing where the team involved in the postpartum hemorrhage review and analyze the clinical management of the situation. The video recording will ONLY be shown to staff members who were involved in the acute event as well as one-two members of the research team. This will typically involve about 5 people (doctors, midwives and assistants). The video recording will subsequently be analyzed by a few people in the research team who are trained in video analysis. The research is only based on the video recordings and not on personal data – neither for the patient or the staff. Therefore, it is not possible to use the video recordings for private interests.

It is important to emphasize that video recording of all normal deliveries and other acute situations will NOT occur. Thus, most deliveries will not be recorded and will not be used in the project.

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Objective

1. To use video debriefing to improve management of postpartum hemorrhage in the delivery ward as well as improve patient care during these events.

2. To developing an applicable protocol for video debriefing of obstetric emergencies, which can be used in the departments in the future.

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Time-frame

The project begins at the Regional Hospital Horsens and at Aarhus University Hospital Skejby in the fall of 2020. We expect the last participants to be recruited by spring 2023.

The results from the project will be available on our website in the fall of 2023.

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Patient information

Participant information

If you are pregnant and scheduled to give birth at Regional Hospital Horsens or Aarhus University Hospital Skejby: During your pregnancy, you will receive written information about the 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 delivery, you develop a postpartum hemorrhage that requires assistance from an emergency team.
  • All persons in the video recording give oral and written consent that the video recording can be used in the project.

YOU CAN NOT PARTICIPATE IN THE PROJECT IF:

  • You or one of the people present on the video recording does not give oral and written consent.
  • You or one of the people present on the video recording 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 5-9 % of all deliveries experience postpartum hemorrhage where video recording will occur. If this happens, you will be asked for written and oral consent that the video recording can be used in the project.

I would like to participate in the project. What should I do?

If you experience postpartum hemorrhage after your birth, you will be able to be a part of the project. You will be asked by the staff at the delivery ward whether you wish to participate. It is not possible to give consent in advance.

I do not want to participate in the project. What should I do?

No video recording of normal deliveries will occur. If the obstetrician comes to the delivery room for simple assessments or other acute situations, the situation is also not included in the project. That is, most deliveries will not be recorded; thus, most pregnant women will not be asked to participate in the project. If you experience a postpartum hemorrhage after your delivery, you will be asked for written and oral consent. If you do not want to participate, the recording 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 video recording will be saved. The video recording will be anonymized, i.e. no personal data or information about the persons involved in the video recording will be available. The video recording will be used when the emergency team will review and analyze their own performance in a debriefing session. The video recording will be shown only to staff members who were involved in your treatment as well as one-two members of the research team. This will typically involve about 5 people (doctors, midwives and assistants). The video will subsequently be analyzed by a few people in the research team who are educated in video analysis. Afterwards, the video recording will be destroyed. The video recording cannot be released to others or displayed in other contexts. 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 videorecording stored?

When a video recording 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 2023.

Can I see the videorecording?

No. The video recording 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. 

I want more information

If you can’t find answers to your questions on this website, you are welcome to contact us under “contact”.

Staff information

Participant information

If you are a staff at Regional Hospital Horsens and Aarhus Universityhospital Skejby, before the project starts, you will receive oral and written information about the project.

YOU CAN PARTICIPATE IF YOU:

  • Are in an emergency team at the delivery ward involved in a postpartum hemorrhage.
  • And all persons in the video recording give oral and written consent that the video recording can be included in the project.

Documents and certificates

In the following, you can find documents and certificates that are used in the project

Statements of consent (danish)

Projectdescription (English)

Patient information (danish)

 Staff information (danish)

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 review of research projects.

Frequently asked questions

Which emergencies are included in the project?

All situations with a postpartum hemorrhage of minimum 1 Liter which requires an obstetrician can be included.  If the obstetrician comes to the delivery room for simple assessments or other acute situations, the situation is not included in the project.

The video recording and subsequent debriefing and analyzes will focus on teamwork. At the top of the “statement of consent” a few additional information such as team of day, total blood loss will be added by the midwife.

Can I say no to participation in the project?

Yes, you can indicate that you do not want to participate. In that case, all video recordings with you will be destroyed without anyone seeing it.

Who is going to see the videorecording?

The video recording will be used when the emergency team will review and analyze their own performance in a debriefing session. The video recording will be shown only to staff members who were involved in the treatment. This will typically involve about 5 people (doctors, midwives and assistants). Present will also be the researcher responsible for the debriefing session. You will be invited to the debriefing within a month after the event has occurred. The video will subsequently be analyzed by a few people in the research team who are educated in video analysis. Afterwards, the video recording will be destroyed.

Where can I find the 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 TEAM OBS Debriefing”. If you cannot find the consent, it can be printed from the projects website found under ”documents and certificates”.

Who is collecting the consent?

The midwife or midwife supervisor obtains consent from everyone in the delivery room and fills in other information on the consent declaration.

How and how long is the videorecording stored?

When a video recording is included in the research project, it is stored according to the guidelines of the Data Protection Agency. All data are stored anonymous until the end of the project in autumn 2023.

If I agree to participate in the project, can I change my decision?

Yes, consent for the project is given according the Danish Act on Processing of Personal Data (§7). It can be withdrawn at any time.

How will I see my video?

You will be invited to video debriefing within 1 month of the postpartum hemorrhage has occurring. During this debriefing, you will, along with the other team members, review the video. The debriefing will focus on clinical management and teamwork.

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”.

They are placed on the wall in the delivery room. Signed
consents should be put in the mailbox with the name ”Project TEAM OBS Debriefing”.
If you cannot find the consent, it can be printed from the projects website
found under ”documents and certificates”.

 

News

06/15/2020
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06/15/2020
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05/23/2018
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Live team nr. 100 videotaped

03/17/2015

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.

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“Trygfonden” donates 430,000 € to the project

02/19/2015

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.

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Live team nr. 50 videotaped

02/03/2015

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. 

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We are now videotaping at Skejby

01/12/2015

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. 

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Donation for 40,000 €

12/18/2014

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. 

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”TV2 Sydjylland”

10/22/2014

There was a piece on the local news in the southern part of Jutland about the project.

 

Read more here

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“TV2 Østjylland”

10/21/2014

There was a piece on the local news in the eastern part of Jutland about the project.

Read more here

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Web-based news media

10/20/2014

The project is mentioned in several forms of the Danish news media.

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First live team is videotaped

10/20/2014

The first real deliveries are videotaped at the Regional Hospital Horsens. It happened on the first day of the project.

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We are ready to videotape real deliveries

10/02/2014

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.

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In situ simulation Skejby

09/11/2014

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.

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Patient information is handed out

09/01/2014

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”.

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In situ simulation Horsens

06/25/2014

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.

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P4

06/25/2014

The project was spoken about on the radio

 

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DR news

06/04/2014

An article was written about the project

 

Link

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Contact

If you have any questions about the project, please contact

Lena Hedegaard Rosvig
Project responsible physician, PhD student

E-mail: lenahede@rm.dk

If you want to receive a phonecall, write it in an email with your phone number.



Funding

  • Information til gravide (Dansk)Trygfonden
  • 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

TeamOBS group

Lena Hedegaard Rosvig

Project manager, PhD student, MD, Aarhus University

Niels Uldbjerg

Main supervisor, Professor in Obstetrics and Gynecology, Aarhus University Hospital

Lise Brogaard

Supervisor, PhD, MD, Aarhus University Hospital

Lone Hvidman

Supervisor, PhD, Consultant in Obstetrics and Gynecology, Aarhus University Hospital

Ole Kierkegaard

Supervisor, Consultant in Obstetrics and Gynecology, Horsens Regional Hospital

Stina Lou

Supervisor, PhD, MA, DEFACTUM, Aarhus 

Tanja Manser

Supervisor, Professor, PhD, MSc, University of Applied Sciences and Arts. Switzerland

Louis Halamek

PhD, Consultant in Pediatrics, Standford University and Packard Children's Hospital