About this trial
The primary objective of this project is to enhance understanding of intrapartum patient safety and person-centered care through the evaluation of an intervention designed to improve team communication and patient involvement during childbirth, thereby positively impacting maternal and infant health.
Despite various efforts to improve safety in intrapartum care, women and their infants are still harmed. Most adverse events within intrapartum care stem from communication and teamwork failures. Despite national and international recommendations, few interventions target patient safety by incorporating person-centered care.
This project will investigate the effectiveness and implementation of the TeamBirth care process developed by Ariadne Labs Boston, U.S. to improve communication and teamwork among caregivers and women during childbirth. The Swedish version of this care process (TeamBirth-SWE) was adapted, tested, and piloted at Karolinska University Hospital during 2021.
Hypothesis: We hypothesize that the TeamBirth-SWE intervention will have a positive impact on interprofessional teamwork, communication, information sharing, patient involvement, and shared decision-making during labor and birth. These improvements are expected to result in improved maternal and infant outcomes, process measures i.e., patient safety climate, interprofessional collaboration, and improved patient reported measures such as patient involvement, shared-decision-making, and satisfaction with care.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Spontaneous onset of labor
Induction of labort
Gestational week >22+0
Disqualifiers
Planned cesarean section
Intrauterine Fetal Demise
Gestational week <22+0, .
Trial population
The study population consist of all women who fulfill the inclusion criteria at the participating labor wards.
Trial design
Cohort
Other
Treatments tested in this trial
The care process S-TeamBirth
BehavioralThe intervention consists of the entire care team conducting huddles together with the birthing woman and her partner to plan the care, using the S-TeamBirth whiteboard to communicate and visualize decisions
S-TeamBirth
BehavioralInvolving the entire care team including the woman and her partner in planning the care using team huddles and the S-TeamBirth whiteboard
Treatment groups
Trial outcomes
Primary outcomes
Birth without major interventions or complications
The primary outcome is a composite measure including provided by the Swedish Pregnancy register and includes the following variables: no operative birth, no postpartum haemorrhage (\>1000 ml), no severe perineal trauma, and a 5-minute Apgar score \>=7.
Shared intrapartum decision-making
Were you involved in planning and decision-making to your desired extent? Likert type question in the Swedish National Pregnancy Survey
Secondary outcomes
Unplanned cesarean section
Mode of birth; caesarean section
Spontaneous vaginal birth
Mode of birth, spontaneous
Instrumental birth
Mode of birth, vacuum extraction/forceps
Postpartum bleeding
Postpartum bleeding in ml, \>500 ml, \>1000 ml
Sponsors and contacts
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Karolinska Institutet
Lead sponsor
Uppsala University Hospital
Collaborator
Region Skane
Collaborator
Region Halland
Collaborator
Region Jämtland Härjedalen
Collaborator
Ariadne Labs
Collaborator
Värmland County Council, Sweden
Collaborator
Region Stockholm
Collaborator