February 2016 - The Labour Assessment Unit on the fourth floor of Royal University Hospital in Saskatoon is where women greater than 16 weeks pregnant come if they are having pregnancy complications or if they are in labour. Ensuring expectant mothers move quickly through this triaging process was the focus of a recent improvement event in Saskatoon Health Region.
Prior to this improvement event, women would present to a registration clerk on the unit and proceed to the nursing desk. At this time, a unit assistant or RN would take them to a room for assessment.
“There was no standardized way to determine how urgent the patient’s condition was and then how quickly they should been seen by a physician,” said Leanne Smith, director of maternal services for Saskatoon Health Region, a co-lead of the improvement team.
So the team implemented the Obstetrical Triage Acuity Scale (OTAS) which objectively categorizes the patient into OTAS groups that have recommended times for both nursing and physician responses. Category 1 is the most urgent, requiring immediate response; Category 5 is the least urgent, where the patient should be seen by a physician within two hours.
Read more here on what this team did.
October 2015 - A dedicated team has done some breakthrough work to make things safer for pregnant women and their babies at Royal University Hospital (RUH) in Saskatoon.
Earlier this year, a mistake proofing team of Saskatoon Health Region staff focused their attention on ensuring the timing of planned caesarean sections (C-sections) is appropriate so that babies born this way are given their best chance to mature.
“Our team worked with the obstetricians to standardize the medical indications for C-sections prior to 39 weeks gestation, when a pregnancy is considered full term, as well as the process for dating a pregnancy,” explained Leanne Smith, a member of the team and the Director of Maternal Services at RUH. “These medical indications are for conditions where it is safer to deliver than to continue the pregnancy either for the baby or mother; for example, twin pregnancies, maternal hypertension or preterm rupture of membranes.”
Before making any of the changes suggested by the team, 1 in 5 planned C-sections at RUH were done before 39 weeks gestation without having one of the approved medical indications for early delivery. This increased the risk of neonatal complications related to baby immaturity.
Read more on how the team developed a Safer Every Day breakthrough here.