Staff undertaking a complex technical task should focus on it and delegate responsibility for looking at the overall picture to a colleague.
When staff are performing a technical task, they need to concentrate on it. Situational awareness will be lost if the task is being performed with due attention. When about to undertake something technical (caesarean section, fetal blood sampling, vaginal breech delivery), staff should actively delegate the job of maintaining a ‘helicopter view’ to someone else. This could be another doctor or another midwife, either onsite or offsite. Staff should learn to recognise when situational awareness is being lost, and the times when people are more prone to this (stressed, fatigued), and practice responding to these in simulations. Human factors training can help in this regard.
All members of the clinical team working on the delivery suite need to understand the key principles of maintaining situational awareness to ensure the safe management of complex clinical situations.
- Avoid distracting someone when they are undertaking or completing a task.
- If multiple tasks occur at once, maintain the role of someone having a ‘helicopter view’ at all times.
- The delivery suite board contains a wealth of information and should be constantly referred to and updated.
- If doctors, midwives or others caring for women in labour feel that they or their team are losing situational awareness, make a challenge and take action. Providers should feel open to constructively challenge other team members to reassess the CTG, or review progress in labour if they feel it is needed.
Ensure that regular simulation happens which incorporates a ‘safe space’ to practise and reflect on personal and team behaviours. Use checklists for common emergencies and drill their use.
A senior member of staff must maintain oversight of the activity on the delivery suite, especially when others are engaged in complex technical tasks.
Ensuring someone takes this ‘helicopter view’ will prevent important details or new information from being overlooked and allow problems to be anticipated earlier.