Obstetrical emergencies are managed by multidisciplinary obstetrical teams. Members of an obstetrical team develop and maintain a shared mental model—an overarching goal for the patient—during an acute event (i.e., emergency delivery) to minimize error and improve patient safety outcomes. The purpose of this mixed-methods study was to examine how members of multidisciplinary obstetrical teams communicate to construct and maintain shared goals, or shared mental models (also known as team mental models) during acute events.

The study (n = 131) examined teamwork sentiments, specifically about team communication and relationships, among individuals (n = 101) who managed acute obstetrical events on a regular basis at three high reliability organizations (HROs). The study also included 30 interviews of individuals at 23 HROs in 19 states that implement variations of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), a validated team training intervention, and regular simulated training programs. Although TeamSTEPPS comprises multiple components, the focus of this study is the intersection of communication and situation monitoring, two realms by which teams create and maintain shared mental models.

Communication (frequency, timeliness, accuracy, and focus on problem-solving) and relationships (shared goals, shared knowledge, and mutual respect) among clinicians were assessed with Relational Coordination, a validated diagnostic tool, at three institutions. The survey results verified strong and above-average ties between the workgroups in all seven dimensions. Results from qualitative interviews revealed patterns of organization, preparedness, and anticipation in the teams’ communication and awareness strategies to build and maintain shared mental models. Organizations that strive to be highly reliable promote exemplary multidisciplinary team performance and integrate simulated training to achieve optimal outcomes, including continual increases in rates of patient safety, lower levels of error, elevated effectiveness, and a common language that can be applied in training. This knowledge can support medical educators, medical officers, facilities, and teams to communicate, build trust, and perform urgent tasks efficiently.