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Pettker CM, Thung SF, Norwitz ER, et al. Am J Obstet Gynecol. 2009;200:492.e1-8.
A multifaceted approach to patient safety resulted in improvements in both patient- and provider-related outcomes over a 3-year time frame. The strategy was developed after consultation with obstetric safety experts and included teamwork training, standardization of care protocols, and establishment of a robust quality assurance mechanism (including a dedicated patient safety nurse). Progressive implementation of the safety interventions was associated with a steady reduction in maternal and fetal adverse events, as well as improvement in the overall perception of safety culture (as measured by the Safety Attitudes Questionnaire). Prior research has demonstrated the effectiveness of crew resource management training in improving obstetric safety.