Why is teamwork important in OB/ #OBAnes? @mbrrace suggests some lessons to be learned. Prompt action is arguably reliant on good communication, within & between teams. Involving consultant/ specialist care early has been a theme for over a decade. #OAA23ASM
@DOckendenLtd’ final report highlighted “conflicting agendas and poor teamwork” contribute to adverse maternal & neonatal outcomes? So how do we create good teams?
How do you create a high performance team environment? Define your “why”. 5 R’s applicable to #OBAnes too. “Buy in” - the 🐘 in the change room and operating room? #OAA23ASM
“The disease of ME” really struck a chord with the audience at #OAA23ASM. Good teams become great when it becomes WE. There’s no I in team… although sometimes hidden in the A hole. Are you contributing or contaminating your team.
Team performance is as important away from the lights as in front of them. Practice play should be as important as the important game. As per @Airwayman1 at #OAA3dc2022, you don’t rise to expectations, you sink to most basic competence level. Experts are ALWAYS made, not born.… twitter.com/i/web/status/1…
High fidelity #OBAnes emergency simulation improves competence. Teamwork in simulation resulted in improved knowledge, skills, communication and team performance. How? Nail the basics. Protect your standards/ values and hold people accountable (this will create tension but it’s… twitter.com/i/web/status/1…
Team conflict triggers fight/ flight response, maladaptive in high-pressure scenarios. Need FUNCTIONAL CONFLICT. @AmyCEdmondson’s psychological safety (see her “Teaming” lecture from #SOAPAM2023, on my timeline) - common misconceptions, not about being nice (necessarily) & you… twitter.com/i/web/status/1…
How do you deal with failure? To err is human, what did we learn? Get as many perspectives as possible. We need a growth mindset! Growth mindset acquired through effort and practice, learning from setbacks. Appropriate Michael Jordan quote. #OBAnes#OAA23ASM
Physiological changes in pregnancy. Normal LFT/ laboratory changes. #OBAnes#OAA23ASM
Causes of liver derangement in pregnancy: flare of pre-existing liver disease (known or unknown). Incidence of pregnancy in people with chronic liver disease at King’s College Hospital. Historically, cirrhotic patients have been infertile d/t anovulation. Population based data… twitter.com/i/web/status/1…
Definition of acute SMM: severe, life threatening event during pregnancy & within 6 weeks of delivery. @NPEU_UKOSS provides UK wide high quality obstetric surveillance. Deaths, while uncommon, investigated in depth.
Prof Donald Peebles on Embedding Maternal Medicine Networks at #OAA23ASM. Knowing who to call is half the solution to any problem? (Touched on by @elsmere_g during #OBAnes session at #Anaesthesia2023)
Direct maternal mortality rate per 100,000 maternities had been decreasing over the last 2 decades, but should a remarkable upswing since 2018, not all accounted for by #COVID19. @mbrrace outlined a case for change: most parts of UK have MDT, but make up variable most without… twitter.com/i/web/status/1…
The Maternal Medicine Network (MMN) mandate: ensure timely access to specialist advice and care at all stages of pregnancy. Development of Maternal Medicine specialist centres as regional hub & spoke model = urgent national priority (@DOckendenLtd report)
The history of @NAPs_RCoA projects and key findings for #OBAnes over the years (failed intubation NAP4 1:390, recent US data 1:808 - gotten better or different methodology?) #OAA23ASM
At the outset, @Rose_Kearsley addresses the definition of trimester (3 months, not only “a third of”). It’s not a novel concept - in lay, academic and anesthesia literature - which makes sense when one thinks of how many pregnancy-associated disease extend beyond delivery (not… twitter.com/i/web/status/1…
#OBAnes workload. 33.3% time on procedures. NB average workload does NOT reflect ebbs & flows, more so surges of activity. @NAPs_RCoA NAP7 data: majority of labour analgesia 1800-0800; #OBAnes accounts for majority of single speciality #AnyAnes work 1800-0800; increasing obesity… twitter.com/i/web/status/1…