Nov 8, 2018

Please Don’t Hide the Forceps

This intriguing story of the Chamberlen family makes the case for sharing what has worked for us in healthcare improvement. Back in 17th century England, the Chamberlen family bucked the trend. Although most babies in those days were delivered by female midwives, the Chamberlen men were well-known for generations for their obstetric skills.

William Chamberlen arrived in England from France and worked as a pharmacist. His family was famous in the midwifery world for their ability to deliver babies safely. William’s son, Peter, attended the childbirths of the wives of King James I and King Charles I. The Chamberlen family was known for their skills in safely delivering babies who presented in the breech position. Back then babies in the breech position frequently died, and their poor mothers also died with them in child birth. The family was also well-known for their skills in managing difficult and obstructed labor. This was especially timely given the prevalence of vitamin D deficiency rickets back then, which caused pelvic deformities in women and subsequent problems with childbirth.

Peter Chamberlen
Turns out that the Chamberlen family’s success came from their proprietary obstetric forceps, variations of which are used to this day in difficult births. The family designed these forceps and subsequently kept them top-secret. They transported the forceps to the mother’s bedside stored in a large highly decorative wooden box, personally transported by the Chamberlens in a special carriage. The expectant mother was blindfolded to prevent her from seeing the box’s contents, the birth was conducted under blankets, and no one except the Chamberlens were allowed to enter the birthing room.

The Chamberlen obstetric instruments
The story ends with a sordid twist when the Chamberlen's obstetric instruments, including five pairs of obstetric forceps, were discovered hidden under the floorboards of the attic of their family home in 1813. After Peter Chamberlen died, his wife, Ann, stowed them away there for over a century. The instruments are now with the Royal College of Obstetricians and Gynaecologists in London.

I’ve spent the better part of the last decade working in health care quality and deeply appreciate communities of practices or quality improvement collaboratives in healthcare. According to one definition, “Communities of practice are groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly.” Communities of practice can exist face-to-face in physical settings (hospital wards, outpatient clinics) or virtually (online discussion boards, virtual learning collaboratives).

Regardless of the setting, my work as well as those of others has shown that the special sauce in communities of practice in healthcare is the clinician champion – someone who is a passionate advocate for advancing the cause, and believes in sharing and collaborative learning. How do we identify clinical champions? It’s more than expertise. Look for these behaviors - Someone who makes connections between different people, is an enthusiastic cheerleader for the innovation, has the resourcefulness to find and mobilize resources, is savvy about navigating socio-political environments, effectively communicates a compelling vision, gets things done despite resistance or inertia, and is not afraid of sharing what worked or did not work for them. Realize that these are not necessarily the loudest people in the room.

So please don’t hide the forceps. Share your work generously. Imagine how many babies and moms a Chamberlen clinical champion might have saved.

Leave a comment - How do you share what has worked or not worked for you in your healthcare work?

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