Video-assisted team debriefing for real-life management of major postpartum hemorrhage (DBRIEF trial): An interrupted time series analysis.

Viewing video recordings of real-life events during debriefing sessions can enhance recall, deepen understanding, and create additional learning opportunities for healthcare professionals. At the department level, this study aimed to evaluate whether implementing video-assisted team debriefings in labor wards improved obstetric teams' clinical management of major postpartum hemorrhage (PPH, blood loss ≥1000 mL). The DBRIEF trial was an interrupted time series analysis, conducted at two Danish maternity units: one secondary and one tertiary. The study included women who experienced major PPH following vaginal birth across three periods: (1) a "Baseline" period (January 2020-September 2020), (2) an "Assessment-only" period (October 2020-September 2021), and (3) an "Assessment-&-debriefing" period (October 2021-September 2022). In periods 2 and 3, an automatic video recording system captured major PPH events in all delivery rooms. In period 3, these videos were used for video-assisted team debriefings. At study completion, trained assessors, blinded to date of inclusion, reviewed all video recordings to evaluate teams' clinical performance using the "Team Obstetric Postpartum Hemorrhage" tool (TeamOBS-PPH) and non-technical performance using the "Assessment of Obstetric Team Performance" tool (AOTP). Register-based data on the incidence of major PPH was extracted for all three periods. Comparing the "Assessment-only" period (N = 214) to the "Assessment-&-debriefing" period (N = 202), the clinical performance score of teams increased from 84.8 (95% confidence interval [CI] 83.5-86.2) to 86.9 (95% CI 85.6-88.2) (P = 0.029), and the non-technical performance score increased from 68.0 (95% CI 66.2-69.9) to 74.3 (95% CI 72.6-76.1) (P < 0.001). The incidence of major PPH was 7.6% in the "Baseline" period, 7.5% in the "Assessment-only" period, and decreased to 6.7% in the "Assessment-&-debriefing" period (P = 0.048). Video-assisted team debriefings might serve as a valuable tool to improve obstetric teams' management of major PPH.