Clinical risk management in obstetrics: eclampsia drills

PROBLEM: Infrequent presentation of patients with eclampsia, leading to staff inexperienced in the condition and untested emergency systems. DESIGN: "Fire drill" programme using on-site simulation of patients with eclampsia. SETTING: Tertiary referral obstetric unit. KEY MEASURES FOR IMPROVEMENT: Successful implementation of measures to optimise management of eclampsia. STRATEGIES FOR CHANGE: Rapid activation of emergency team after one call, development and dissemination of evidence based protocol for eclampsia, strategically placed "eclampsia boxes," individual staff feedback and education. EFFECTS OF CHANGE: Efficient and appropriate management of subsequent simulated patients. LESSONS LEARNT: On-site simulation can identify and correct potential deficiencies in the care of patients with eclampsia.