A Safety Evaluation of the Impact of Maternity-Orientated Human Factors Training on Safety Culture in a Tertiary Maternity Unit

Human factors have risen to attention in maternity as key contributors to patient harm. Despite national recommendation for multidisciplinary human factors training, there is a lack of guidance and healthcare-orientated training. OBJECTIVES: The aim of the study was to evaluate the impact of maternity-orientated human factors training program on safety culture in a tertiary maternity unit. METHODS: This prospective observational cohort study was conducted for 6 months in a tertiary maternity unit. Participants involved in high-risk intrapartum care completed the Hospital Survey of Patient Safety Culture before and after intervention. Statistical analysis was performed using the χ(2) test with statistical significance at 5% (P = 0.05). INTERVENTION: The human factors curriculum included situational awareness, communication, decision-making, conflict resolution, teamwork, and leadership. A train-the-trainer approach generated a faculty to disseminate multidisciplinary training. Traditional classroom teaching, social media content, and cognitive activities provided theoretical foundations. Forum theater and behavioral simulation taught complex communication issues. Regular labor ward simulations helped embed training into clinical practice. RESULTS: The results demonstrated statistically significant improvement in safety culture domains of communication openness, handover, nonpunitive response to error, and overall safety perception. Participants felt more able to challenge decisions or actions of those in authority, 33% responded “most of the time or always” in August increasing to 42% in January with a reduction of 50% in those responding “never” (P = 0.02). No change was found relating to team working, staffing or manager expectations promoting patient safety. CONCLUSIONS: This study is proof-of-concept that maternity-orientated human factors training can improve safety culture.