Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Nov;209(5):402-408.e3.
doi: 10.1016/j.ajog.2013.07.013. Epub 2013 Jul 17.

Confronting safety gaps across labor and delivery teams

David G Maxfield  1 , Audrey Lyndon, Holly Powell Kennedy, Daniel F O'Keeffe, Marya G Zlatnik
Affiliations

Confronting safety gaps across labor and delivery teams

David G Maxfield et al. Am J Obstet Gynecol. 2013 Nov.

Abstract

We assessed the occurrence of 4 safety concerns among labor and delivery teams: dangerous shortcuts, missing competencies, disrespect, and performance problems. A total of 3282 participants completed surveys, and 92% of physicians (906 of 985), 93% of midwives (385 of 414), and 98% of nurses (1846 of 1884) observed at least 1 concern within the preceding year. A majority of respondents said these concerns undermined patient safety, harmed patients, or led them to seriously consider transferring or leaving their positions. Only 9% of physicians, 13% of midwives, and 13% of nurses shared their full concerns with the person involved. Organizational silence is evident within labor-and-delivery teams. Improvement will require multiple strategies, used at the personal, social, and structural levels.

Keywords: communication; organizational silence; patient safety; psychological safety.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. The Joint Commission. Sentinel Event Statistics Data – Root Causes by Event Type (2004 -Q4 2012) Sentinel Event Statistics. 2013 http://www.jointcommission.org/assets/1/18/Root_Causes_Event_Type_04_4Q2... Accessed February 9, 2013.
    1. Belyansky I, Martin TR, Prabhu AS, et al. Poor resident-attending intraoperative communication may compromise patient safety. J Surg Res Dec. 2011;171(2):386–394. - PubMed
    1. Maxfield D, Grenny J, Lavandero R, Groah L. The Silent Treatment: Why Safety Tools and Checklists aren’t enough to Save Lives. 2011 http://www.silenttreatmentstudy.com/download/
    1. Aiken LH, Cimiotti JP, Sloane DM, Smith HL, Flynn L, Neff DF. Effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments. Med Care Dec. 2011;49(12):1047–1053. - PMC - PubMed
    1. Friese CR, Lake ET, Aiken LH, Silber JH, Sochalski J. Hospital nurse practice environments and outcomes for surgical oncology patients. Health Serv Res Aug. 2008;43(4):1145–1163. - PMC - PubMed

Publication types