Dorothy had the shoes but she didn't have the vision

September 15, 2005

We have the technology to enhance patient safety and care. Now we have to use it.

Drs. Park and Norwitz have provided an excellent review of new technologies for obstetric practice. They have detailed the advantages and disadvantages of advanced ultrasound techniques, early fetal genetic diagnoses, and the role of proteomics in the detection of amniotic fluid leakage.

In the August 17th issue of JAMA, Dr. Ben Sachs, Chair of Ob/Gyn at the Beth Israel Hospital in Boston, described how a sentinal event at their hospital-a poorly-handled case of fetal loss and emergency hysterectomy-motivated his department to dramatically alter their practice and training. His team took a lesson from the airline industry, which since the 1970s has shown that team training can reduce the kinds of critical errors that cause catastrophic events. Dr. Sach's goal is to enhance communication among all members of the obstetric team in order to reduce critical errors. In this edition of Contemporary OB/GYN, Drs. Gardner and Walzer describe several obstetric simulators that are also currently being used to help with team training as well. They describe the reduction in malpractice insurance rates that have occurred for participants in the team training, as well. Such simulators are just the tip of the iceberg; however,
I believe that simulation will ultimately be an integral part of surgical and obstetric training, certification, and re-certification.