Patient Safety: The Most Important Bottom Line

At its annual meeting in September 2012, the Washington State Medical Association (WSMA) awarded the William O. Robertson Patient Safety Award to Physicians Insurance. Physicians Insurance was recognized for its innovative work in developing simulation training programs around shoulder dystocia, and then launching those programs within urban and rural hospitals. Shoulder dystocia, an obstetrical emergency that is infrequently encountered, requires the best of teamwork for positive outcomes; however, each time the emergency occurs, there is typically a new team of staff and providers working together.

Angela Chien, MD, who practices obstetrics and gynecology at Evergreen Women’s Health Center in Bellevue, Washington, noted they had run simulations in the past but they were infrequent events, and not mandatory for staff or providers. That made it difficult to determine if the simulations were making a difference in patient safety. She says that “the first day of simulation with Physicians Insurance felt like Christmas morning” and appreciated having the ability to simulate shoulder dystocia and practice the maneuvers. “For many of our staff, this was their first simulation experience that involved providers and other staff members in addition to a staff member serving as a patient. The response was overwhelmingly positive. It was clear that simulation was something worth doing for every obstetrical emergency.”

Dr. Chien noted that at a recent Patient Safety Summit, drills were touted as one of the best safety practices they have implemented in the last year. Moving forward, they plan to provide mandatory simulation training three times a year, covering every obstetrical emergency at least once during that cycle. And it has made a difference. Says Chien, “Just one week after postpartum hemorrhage drills, I had an actual patient who suffered from significant bleeding after a scheduled Cesarean section. My team worked beautifully and they were confident in their abilities. I utilized a technique I learned in the simulation training. As a team, we were able to save the patient while avoiding more extensive surgery or an ICU admission.”