Please confirm that an ethics committee approval has been applied for or granted: Not relevant

Background and Aims The provision of care by the medical team must have an immediate and positive impact on the health and safety of patients. It is increasingly important to rely on cooperative teams in the healthcare field due to the rising complexity and specialization of care and the general labor shortage. Aim:To study the pillars of communication and collaboration between anesthesiologists and paramedical staff using the example of the maternity ward and to identify the causes of poor communication among the obstetric care team.

Methods This is a survey using two questionnaires: the first addressed to midwives and the second to anesthesia technicians working in level III maternity wards. It is a descriptive study conducted within the obstetrical units (delivery room and operating room) of four Tunisian university hospitals

Results Seventy-three midwives and sixty-eight anesthesia technicians responded to our questionnaires. The relationship with the anesthesiologist was satisfactory in 67.9% and 72.9% of cases, respectively. The two main causes of poor communication were workload and lack of organization in over 60% of cases. The implementation of a service protocol guiding the call of the anesthesiologist in critical situations improved communication among the different stakeholders and significantly reduced the response time to calls (p=0.034). The proposed suggestion was basic training for all healthcare personnel on communication through high-fidelity simulation sessions.

Conclusions Our study suggests that midwives and technicians do not have sufficient knowledge of their scope of practice, and that workload and lack of organization are the major causes of poor communication.