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Multidisciplinary Delphi Development of a Scale to Evaluate Team Function in Obstetric Emergencies: The PETRA Scale

      Abstract

      Objective

      The objective of this study was to develop a new interdisciplinary teamwork scale, the Perinatal Emergency: Team Response Assessment (PETRA), for the management of obstetric crises, through consensus agreement of obstetric caregivers.

      Methods

      This prospective study was performed using expert consensus, based on a Delphi method. The study investigators developed a new PETRA tool, specifically related to obstetric crisis management, based on the existing literature and discussions among themselves. The scale was distributed to a selected panel of experts in the field for the Delphi process. After each round of Delphi, every component of the scale was analyzed quantitatively by the percentage of agreement ratings and each comment reviewed by the blinded investigators. The assessment scale was then modified, with components of less than 80% agreement removed from the scale. The process was repeated on three occasions to reach a consensus and final PETRA scale.

      Results

      Fourteen of 24 invited experts participated in the Delphi process. The original PETRA scale included six categories and 48 items, one global scale item, and a 3-point rubric for rating. The overall percentage agreement by experts in the first, second, and third rounds was 95.0%, 93.2%, and 98.5%, respectively. The final scale after the third round of Delphi consisted of the following seven categories: shared mental model, communication, situational awareness, leadership, followership, workload management, and positive/effective behaviours and attitudes. There were 34 individual items within these categories, each with a 5-point rating rubric (1 = unacceptable to 5 = perfect).

      Conclusion

      Using a structured Delphi method, we established the face and content validity of this assessment scale that focuses on important aspects of interdisciplinary teamwork in the management of obstetric crises.

      Résumé

      Objectif

      Cette étude visait à élaborer, par consensus de fournisseurs de soins obstétricaux, une nouvelle échelle d'évaluation du travail d'équipe interdisciplinaire applicable à la prise en charge des situations d'urgence en obstétrique, la Perinatal Emergency Team Response Assessment [Évaluation d'une équipe d'intervention en cas d'urgence périnatale], ou PETRA.

      Méthodologie

      Cette étude prospective repose sur un consensus d'experts établi selon une méthode Delphi. Les chercheurs ont mis au point l'échelle PETRA, qui s'applique précisément à la prise en charge des urgences obstétricales, en utilisant la littérature existante et les résultats des discussions entre membres. Pour l'enquête Delphi, l'échelle a été distribuée à un groupe d'experts choisis du domaine. Après chaque tour d'enquête, les chercheurs analysaient quantitativement chaque élément de l'échelle, selon les pourcentages d'accord reçus, et passaient en revue chaque commentaire. Cet examen en aveugle menait ensuite à la modification de l'échelle : les éléments ayant moins de 80 % d'accord étaient retirés. Répété trois fois, le processus a mené à l'établissement d'un consensus et d'une version définitive de l'échelle PETRA.

      Résultats

      Sur les 24 experts invités, 14 ont participé à l'enquête Delphi. L'échelle initiale comprenait 48 éléments regroupés en six catégories, un élément général et un système de notation sur trois points. Le pourcentage d'accord global aux premier, deuxième et troisième tours était de 95,0 %, 93,2 % et 98,5 %, respectivement. Après le troisième tour, l'échelle comptait sept catégories : modèle mental commun, communication, conscience de la situation, direction, respect de la hiérarchie, gestion de la charge de travail, et attitudes et comportements positifs et efficaces. Ces catégories rassemblaient 34 éléments, notés sur une échelle de cinq points (1 = inacceptable; 5 = parfait).

      Conclusion

      Nous avons suivi une méthode Delphi, un processus structuré, pour établir la validité de l'organisation et du contenu de l'échelle d'évaluation PETRA, qui porte sur des aspects importants de la collaboration interdisciplinaire dans la prise en charge des situations d'urgence en obstétrique.

      Key Words

      Abbreviation:

      GAOTP (Global Assessment of Obstetric Team Performance), GRS (Global Rating Scale), NICU (Neonatal Intensive Care Unit), PETRA (Perinatal Emergency Team Response Assessment)
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