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Table 5 Overview of goals and achievement rates in three categories: training, system and infrastructure, and teamwork

From: Team training in obstetric and neonatal emergencies using highly realistic simulation in Mexico: impact on process indicators


Number of goals identified (124 total)

Number of goals achieved (73 goals, 58.8%)

Examples of goals achieved

Examples of goals not achieved



28 (80%)

Replicate simulation scenarios with PartoPants™

Train in manual uterine vacuum aspiration

Train other personnel in Active Management of the Third Stage of Labor

Improve record keeping for charts

Train additional personnel in teamwork concepts


Train additional personnel in communication rules


System and Infrastructure


30 (53%)

Implement an alarm system useful throughout the hospital, emergency department, labor and delivery, pediatrics

Acquire new ambu bags for neonatal resuscitation

Acquire medications such as Misoprostol, Oxytocin

Establish meetings between hospital Director and local government health authorities

Refrigeration of oxytocin and/or ergonovine

Access to locked ultrasound machine evening and weekends

Move refrigerator close to delivery room

Reorganize shift coverage to make sure adequate care available

Create inventory of available medications for obstetric emergencies

Specialty care available in all shifts

Repair ambulance


Teamwork and Communication


15 (45%)

Post and promote characteristics of a strong leader

Improve work environment through courses and seminars

Use communication rules with colleagues and explain their use to non-PRONTO trained colleagues

Establish system of individual stimuli for better attitude and teamwork- “provider of the month”ss

Meeting between PRONTO participants and hospital authorities, Medical and Nursing Directors, to discuss action plan and implementation