On March 2, Step Up Together launched our new Quarterly Community Debriefs with a discussion focused on First Stage Fetal Bradycardia and intrapartum transfer from community settings.
Community Debriefs are 60-minute sessions that bring together professionals across the maternity care system—community midwives, hospital teams, EMS personnel, educators, and quality improvement leaders—to reflect on what happens when teams run Step Up Together transfer drills in their own settings.
Several participants shared their experiences running the First Stage Fetal Bradycardia Full Transfer Drill, a scenario designed to test how teams recognize fetal emergencies, initiate escalation, and coordinate intrapartum transfer for further monitoring and potential emergency delivery.
Here are a few key takeaways from the discussion.
Every Role in a Drill Matters
Running a meaningful drill takes preparation—and every role contributes to the learning experience.
Clinical providers, drill observers, facilitators, and even the person playing the patient help create the realism that allows teams to test communication and decision-making under pressure. In one team’s experience, the drill did not unfold as intended because the simulated patient was not well prepared for the scenario.
The takeaway: strong drills start with strong preparation.
If you are planning a drill, check out our blog post: Preparing the Drill Patient for Optimal Drill Fidelity.
Transfer Decisions Are Not Always Straightforward
Participants also discussed the complex clinical decisions that arise when transferring a patient during labor—particularly in rural areas.
One topic that generated discussion was the risk–benefit balance between transferring via private vehicle versus EMS. These decisions depend on many factors including geography, EMS availability, patient condition, and transport time.
Debriefing these decisions across agencies—community providers, EMS teams, and receiving hospitals—can help ensure everyone understands the clinical reasoning and strengthen collaboration for future events.
Full Transfer Drills Reveal System Gaps
Teams consistently shared that Full Transfer Drills, which simulate movement of a patient across the entire system—from community practice to EMS to hospital—are powerful for identifying delays and communication gaps.
These exercises often reveal system issues that are difficult to see otherwise, including:
- handoff communication challenges
- equipment or documentation gaps
- unclear roles during urgent escalation
Even small teams can begin with Partial Transfer Drills or table reads and build toward full interdisciplinary simulations over time.
A Moment to Strengthen Intermittent Auscultation Across Settings
Because fetal bradycardia is often first recognized through intermittent auscultation (IA), participants also reflected on the importance of maintaining strong fetal assessment skills across care settings.
With new national guidelines for intermittent auscultation emerging for both community birth and hospital environments, this is an important moment to strengthen collaboration and shared standards for fetal assessment across levels and locations of care.
To support this work, Step Up Together recently launched our Intermittent Auscultation Simulation-Based Education Course, a self-paced program using animated clinical simulations to help interdisciplinary teams build confidence in fetal assessment and response.
A Growing Community of Practice
The Quarterly Community Debrief series creates space for teams to learn from each other’s experiences running drills and improving transfer systems.
Whether you are actively running drills or just beginning to explore simulation as a quality improvement tool, these sessions offer practical insights for strengthening teamwork and emergency preparedness.
Because when emergencies happen, teams that practice together respond better together.
Register Now – It’s Free!
There’s still plenty of time to join our next Community Debrief. On June 1, we will debrief a postpartum transfer using our Retained Placenta with Doula Present Drill Kit. Register today!
