Most clinicians involved in labor and delivery observed their colleagues taking shortcuts or demonstrating other problematic behavior -- which most believed jeopardized patient safety -- but few spoke up about it, according to a new study in which AWHONN played a key role. In the study of nearly 3,300 clinicians, published online in the American Journal of Obstetrics & Gynecology, 98% of nurses, 92% of doctors and 93% of midwives reported observing at least one safety concern, including dangerous shortcuts such as not washing hands or performance problems such as poor attention to detail, in the past year. However, only 13% of nurses, 9% of physicians and 13% of midwives shared their concerns with the person involved. The key reasons given for not speaking up were fear that the person would become harder to work with (47%) and desire to avoid conflict in front of the patient (38%). Staff and charge nurses also reported fear of retaliation and that they had seen the person get angry at someone else who had confronted them. AWHONN helped initiate and implement the study, in partnership with the American College of Nurse-Midwives, the American Congress of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, all of whose members were surveyed. Read the abstract.