Multi-professional training for obstetric emergencies in a US hospital over a 7-year interval: an observational study

OBJECTIVE: Birth is less safe than it can be. We adapted the UK-developed PROMPT (TM) (PRactical Obstetric Multi-Professional Training) course to local practices and initiated annual training. STUDY DESIGN: This observational study used quality assurance data from University of Kansas Hospital 2 years before and 7 years after intervention encompassing 14 309 consecutive deliveries from January 2006 through December 2014. An events/trials approach was applied to changes in proportions over time. RESULT: PROMPT (TM) was associated with progressive decreases in rates (P < 0.05) of brachial plexus injury and umbilical artery pH < 7.00 exclusive of catastrophic events. Reduced rates (P < 0.05) of cesarean section, episiotomy and higher perception of nurse/physician communication were documented. Hypoxic ischemic encephalopathy (HIE) rates declined progressively by > 50% (P = NS). These improvements occurred despite younger faculty and higher rates of complicated pregnancies (P < 0.05). Estimated health-care costs avoided exceeded annual training costs. CONCLUSION: Local annual multi-professional training as provided by PROMPT (TM) was temporally associated with improved obstetric outcomes.