Five common ways communication breaks down in a maternity unit (and how to avoid them)

Clear concise communication within the multidisciplinary team and across organisational boundaries is pivotal to the delivery of safe quality care. When the methods of communication are based on a hybrid model encompassing paper and electronic notes there is a risk of suboptimal communication within a health care setting. This can potentially lead to serious adverse outcomes across the maternity pathway.

We spoke to Misbah Mahmood, Digital Midwife at Leeds Teaching Hospitals NHS Trust (LTHT), to hear her thoughts on how digital solutions can be used to combat common communication breakdowns in a maternity unit.

Consolidating all notes

Maternity units are at varying stages in their transition to a fully integrated electronic maternity records system. It’s a positive step in the right direction but a stage that’s not without its challenges. A hybrid model increases the risk of the practitioner not having all of the relevant documentation easily accessible and therefore may create challenges when formulating a plan of care.

“This may impact the care that the woman and baby receive due to incomplete documentation; however, whilst this is not ideal this risk is recognised and mitigation is in place to minimise this risk,” explains Misbah.

She adds that digital maternity solutions like K2 Athena consolidate all records, which is beneficial not just for the current pregnancy but for any subsequent pregnancies. “You no longer have to pull out the brown paper notes, you just go to the archives and look at the woman’s previous history,” she says.

Connecting community midwives

Electronic maternity records also enable community midwives to access all of the other Trust IT systems which historically have been more challenging to access for midwives who are not working on-site. This also has benefits in terms of saving time at points of increased acuity and capacity as it eradicates the need for multiple phone calls to other services.  Digital maternity records enable midwives and other members of the team to remotely access everything on a woman’s record. This has a positive impact on the timeliness of providing information and answering queries as the woman doesn’t have to wait for the midwife to ring the hospital to get further information.

“I feel like the community midwives feel a bit more connected to the hospital,” says Misbah. “Now they just log onto Athena from anywhere and they can have a look. It’s all audited as well so they feel more secure.”

Facilitating safer care

COVID-19 has impacted pathways of care throughout the Health Service. The maternity services have had to make adjustments in line with emerging evidence from expert groups. Pregnant women are included in the list of people who are at moderate risk, while all healthcare staff need to take every possible precaution to both protect themselves and stop the spread of the virus. This can be challenging for community midwives, for whom it may not be instantly clear whether a woman has received a positive COVID-19 test or whether she is waiting for test results. This is no longer an issue for LTHT, which has just had the COVID functionality updated in Athena.

“It highlights any women who are COVID positive and any women who are waiting for results,” explains Misbah. “This enhances communication and ensures that appropriate risk assessments can be undertaken prior to the delivery of care. This is particularly relevant in protecting staff and women in the event of a positive COVID-19 swab.”

No more missing phone records

Historically when a woman phoned the hospital for advice this was logged in a separate paper book. Although all of the relevant information was still available, the electronic record provides a platform for all of the contemporaneous documentation to be viewed in one defined area. This enables prompt oversight of all contact episodes and enables seamless communication with the woman.

“We record all our phone calls on K2,” explains Misbah, referring to how the maternity units at LTHT solve this common issue. “Now it’s easy to find that information. Having the data collated in one place within the woman’s medical record enhances analysis of records if investigations due or complaint reviews are required.”

Improving data shared between sites

Data analysis is an integral part of improving care and can contribute towards quality improvements within the maternity services. But as with all things, you get out what you put in. Managing the data and producing reports when it is stored in different locations requires an immense amount of organisation which even the most meticulous of people can struggle with. Misbah has found that using a digital solution to capture and manage the data enhances the ability to audit records when required.

“LTHT have two sites, LGI and St. James’, and are part of the West Yorkshire and Harrogate local maternity system. Each month, LTHT collate data to populate the local and regional dashboard to identify performance against key indicators. Now that LTHT have a fully integrated end-to-end electronic system, reports can be extracted within minutes to accurately inform internal and external stakeholders of the quality and safety of care within the maternity services.”