Delivering better outcomes for patients across Nova Scotia

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“She really should win an Oscar for her portrayal as a woman in labour,” Leanne MacKeen, perinatal nurse consultant, laughs. “She even had me convinced!”

The ‘actor’ she refers to is her colleague at the Reproductive Care Program of Nova Scotia (RCPNS), Leeanne Lauzon, and they (along with partners at the IWK) are running a simulation session at one of the regional hospitals in the province.

“The focus is on optimizing outcomes for patients, and the ultimate goal of simulation is preparation,” Lauzon says. “For many of the folks working in emergency departments (EDs) in the regional or community hospitals, delivering a baby is an emergency because they don’t often do it. For the perinatal units across the province, they thankfully don’t often face critical events and so simulation gives them an opportunity to anticipate how they’re going to coordinate care.”

“The Pregnant Woman in the ED” is a four-hour workshop for health professionals in community hospitals in Nova Scotia without an active labour and birth service. In addition to supporting unplanned birth, topics include recognizing and managing obstetrical emergencies, as well as less urgent symptoms and complications that prompt women to seek care in the emergency department.

Heather Ezurike, perinatal nurse consultant, RCPNS, says their objective is to optimize outcomes for women and babies throughout the province. “The RCP clinical team brings our understanding of trends in perinatal care to our work with teams and we assist them to create solutions that address their identified needs or potential issues. We help teams build on their own strengths or bridge new partnerships”.

“We’re more like facilitators in the fact that we help them think about it from a different perspective. There are many resources health professionals can refer to manage obstetrical complications, but these are often written as a one-size-fits-all approach. We at RCP help teams think about the concepts and apply this knowledge within their team’s own contexts,” Ezurike says. “Their reality is likely very different and they may have fewer team members, different equipment, etc. We train and educate on things like improving communications or team dynamics. We help them think beyond their unit – who can you reach out to in other departments? Intensive Care Unit/Emergency Department/Operating Room? People are there to help and support.”

Mackeen says their work is mostly about building relationships. “A lot of the people in the regional hospitals have the same clinical expertise as we do, but maybe not the same experience with particular situations,” says MacKeen. “We have to build trust and awareness with them, too. They ought to know they can call us if they identify a need or if something happens, and not be viewed with judgment.”

Lauzon says a change in demographics is prompting calls for more simulation sessions as many experienced nurses and physicians retire and take that expertise with them. “Specific clinical situations require a team-based approach and the practice gives them the opportunity to plan for emergencies and feel more confident about their preparation. The debrief discussion with the team following the simulation is always really rich; without fail, professionals from different backgrounds can appreciate where they fit into the scenario to be most helpful, and they can see the perspective of other team members including support staff. Sometimes this is can be really eye-opening and so it’s excellent learning.”

“We’re seeing a real readiness from regional hospitals for us to partner with them and help run these sessions,” Lauzon says. “There’s plenty of room to grow and expand and we are ready and excited for what the future holds.”