The MOREOB ProgramTM
Managing Obstetrical Risk Efficiently
 The MOREOB Program has been delivering results for more than five years to thousands of caregivers, their obstetric teams, their hospital’s quality performance, and to the women they care for.
Initially developed by the Patient Safety Division of the Society of Obstetricians and Gynaecologists of Canada (SOGC), MOREOB is a comprehensive, three-year, patient safety, professional development, and performance improvement program for caregivers and administrators in hospital obstetrics units. The Program structure is based on the proven principles of High Reliability Organizations (HRO’s) including: safety as the priority, effective communication, teamwork, decreased hierarchy in emergencies, practice for emergencies, and reflective learning.
Evidence-based clinical content, skills drills, emergency drills, communication and teamwork tools, and reflective learning techniques are provided within a “train-the-trainer” approach. An interprofessional Birthing Unit Core Team made up of hospital-based frontline and administrative personnel leads the implementation of MOREOB activities. Core Team training is facilitated by an interprofessiona lMOREOB Instructor team. Evaluation tools are used by the Core Team to measure and report progress, guide improvements, and identify and celebrate successes. Core Teams are supported in their leadership roles by MOREOB Regional Representatives.
Three primary program modules support the development of an effective and sustainable patient safety and team performance culture:
- Learning Together – increases interprofessional core knowledge in common obstetrics and patient safety topics
- Working Together – creates value in and from communication, relationships and team function
- Changing the Culture – locks in the improvements to sustain the team’s performance and prepares them to take on new challenges.
Following success in the three primary program modules, teams are encouraged to continue to work towards sustainability of their success from MOREOB through the Advancing with MOREOB (AwM) by engaging in focused commitments that build on those successes.
By learning and working together in their own setting the healthcare team is able to use the shared knowledge, skills, attitudes, and behaviors that contribute to safe, effective, patient-centered care in an efficient, collaborative, healthy practice environment.
Modules 1,2 and 3, the primary program modules in the first three-year commitment to MOREOB, provide teams with the basis for significant improvements in knowledge, practice standards, and team function, and help to create a culture of safety and enhanced performance.
 Module 1: Learning Together focuses on creating a shared knowledge base by providing all participants with evidence-based clinical content, learning tools, skills drills, and interprofessional workshops – all excellent interprofessional learning opportunities and team-building activities.
Clinical content is developed and updated annually by the Obstetrical Content Review Committee of the SOGC. Learning results are significant with teams typically recognizing performance improvements that contribute to the hospital’s key business goals.
In Module 2: Working Togetherenables the learning results to continue as the emphasis shifts to interprofessional team performance. Teams learn and practice enhanced team function and communication methods that contribute to a healthy working environment. Emergency drills and audits are introduced to help frontline workers to identify potential improvements in organizational practices and systems. These activities further address the organization’s goals.
Module 3: Changing the Culture ensures that learning results become an integral part of the team’s environment. Performance is seen as a team effort, and practice improvements that stress patient safety are the main objective. Teams learn from no-harm and harm event reviews using a root cause analysis (RCA) approach. They are introduced to Communities of Practice as a methodology for capturing and managing system improvements. In each module, teams are evaluated to measure progress, guide improvements, and identify successes. Strong positive results are typically recorded in Learning and Performance. These improvements ultimately influence Organizational Results.
Learning Results |
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Performance Results |
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Organizational Results |
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Increased core clinical knowledge.
Understanding of High Reliability Organization principles and their implications in improving patient safety.
Enhanced interprofessional communication and teamwork skills.
Knowledge of techniques to assess unit and personal practice.
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An improved patient safety culture.
Enhanced confidence in managing emergencies and routine situations.
Improved team effectiveness in managing situations and emergencies.
Improved work practices critical to patient safety.
Revised protocols and policies as a result of reflective learning.
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Improved clinical outcomes in areas such as shoulder dystocia, latent phase of labor management, postpartum hemorrhage, induction of labor.
Reduction in no-harm and harm events.
A healthier workplace.
e.g. Improved job satisfaction.
Improved patient satisfaction
Improved productivity and lowered operating costs.
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