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Accredited by the American College of Surgeons and endorsed by the American Society of Anesthesiologists.
Labor and Delivery Simulation Courses
Patient safety, teamwork and crisis resource management
Patient safety is an integral component of healthcare and many efforts are underway to reduce medical errors and injuries and malpractice claims that result from them. Obstetrical and surgical adverse events often involve failures of team performance The increasingly high cost of obstetrical malpractice claims has made patient safety and error reduction priorities for loss prevention interventions, with a focus on interventions that improve teamwork and communication.
Labor and Delivery clinicians can improve their skills in managing and debriefing routine and critical clinical events; managing difficult conversations and disclosure and apology for adverse clinical events. There is now a well publicized need to facilitate a culture of safety, creating an environment that is more open to discussion of medical errors and how team performance can mitigate such errors. By providing training, reflection and deliberate practice in these areas, the course in Crisis Resource Management for Labor and Delivery clinicians addresses these needs that are not provided in any other venue.
The Labor and Delivery Crisis Resource Management Course was originally designed for obstetrical nurses, midwives and physicians from Harvard’s Risk Management Foundation (RMF).
Harvard RMF/CRICO provides a 10%, three-year discount on annual obstetrical malpractice premiums for physicians who complete the Labor & Delivery course at the Center for Medical Simulation, complete RMF CME website coursework and pass a short test on CRICO obstetrical guidelines.
ProMutual Group also offers their insured obstetricians an annual premium discount for completing the Labor and Delivery Crisis Resource Management courses. Please contact your assigned agent directly for further details on how to obtain this discount.
Obstetricians, obstetrical nurses, midwives, and non-CRICO insured anesthesiologists will be charged a tuition to participate in the L&D CRM course.
Learning Teamwork and Crisis Resource Management (CRM) for Labor and Delivery Clinicians (L&DCRM-1)
Course Description
The seven-hour Labor and Delivery CRM experiential course focuses on event management during simulated clinical practice. Participants include obstetricians, obstetrical nurses, midwives and obstetrical anesthesiologists, because collaboration and teamwork among these groups is so important during obstetrical events.
The Center for Medical Simulation provides a realistic medical setting, equipped with all the supplies and devices normally found in Labor and Delivery. Simulated clinical scenarios and obstetrical procedures are conducted using a computerized mannequin and fetal heart rate simulator equipment. Some obstetrical procedures cannot be easily simulated, and require participants to role play, but behave as they would in the real clinical environment.
Participants, view their simulation training on video during structured group debriefings that are facilitated by trained CMS instructors who provide practice and supportive feedback. This instruction is intended to enhance teamwork skills and result in a reduction of adverse events and medical errors in actual clinical settings.
The course curriculum is derived from the review of obstetrical claims data, consultation with obstetrical leadership, experience with anesthesia CRM courses, and feedback from our successful Labor &Delivery CRM programs.
Topics include:
- Factors that degrade long-term vigilance in Labor & Delivery
- Work overload
- Hubris
- Production pressures
- Fixation and being stuck in mental models that seem rational but aren’t
- Tolerance, accommodation and being falsely reassured
- Fatigue
- Communication strategies in event management
- Sharing information with all team members
- Importance of closed-loop communications
- Introducing yourself, your level of experience to your team and vice versa
- Lower threshold
- Calling for help
- Assertiveness techniques
- Strategies for debriefing events and disclosing medical errors
- Being accountable as a member of the team
- Apologizing without accepting blame
- Talking to the patient and family
Tuition
CRICO Insured Obstetricians: $950
CRICO Insured Anesthesiologists from BIDMC, BWH, CHB, and MGH: Tuition has been prepaid by your hospital's Anesthesia Dept.
Other CRICO Insured Anesthesiologists: $950
CRICO Certified Nurse Midwives: $300
Non-CRICO Insured Obstetricians: $1250
Non-CRICO Anesthesiologist: $1250
Non-CRICO Certified Nurse Midwives: $450
Obstetrical Nurses: $150
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Continuing Education Credits
Open Course Dates
Improving Teamwork and Crisis Resource Management for Labor and Delivery Clinicians (L&DCRM-3)
For those who have previously taken Learning Teamwork and Crisis Resource Management for Labor and Delivery Clinicians, this seven-hour course refines and advances principles of CRM for application in real clinical settings.
Topics include:
- Discussion of how participants are applying crisis resource management principles
- Clarifying Roles
- Communicating effectively
- Using support
- Managing resources
- maintaining situation awareness
Participants will:
- Understand and practice the clinical management of high stakes low frequency critical events occurring on Labor and Delivery including resuscitation of mother and newborn
- Practice teamwork skills applicable to Labor and Delivery to improve management of crisis situations
- Understand, practice and demonstrate communication strategies including closed loop communication, explicit and transparent communication
- Demonstrate role of the event manager
- Practice difficult conversations with colleagues and patients including disclosure of adverse perinatal events
- Understand strategies to manage and resolve conflict between colleagues and access the chain of command
- Become familiar with issues of cultural competency when dealing with patients and their preferences and family members
- Practice briefing and periodic re-briefing with the team
- Understand strategies to avoid fixation, why they occur, and how maintaining a loose mental model and stepping back when critical events occur can improve decision making and diagnostic skills
- Understand and demonstrate the performance of a "Plus/Delta" debriefing (What went well? What should be done differently next time) to apply to both crisis and routine events in their own units
Tuition:
CRICO Insured Obstetricians: $950
CRICO Insured Anesthesiologists from BIDMC, BWH, CHB, and MGH: Tuition has been prepaid by your hospital's Anesthesia Dept.
Other CRICO Insured Anesthesiologists: $950
CRICO Certified Nurse Midwives: $300
Non-CRICO Insured Obstetricians: $1250
Non-CRICO Anesthesiologist: $1250
Non-CRICO Certified Nurse Midwives: $450
Obstetrical Nurses: $150
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