Structured pre-delivery huddles enhance confidence in managing newborns with critical congenital heart disease in the delivery room

Newborns with critical congenital heart disease (CCHD) require specialized delivery room management, but varying experience and knowledge can reduce confidence and impact care. A pre-delivery, structured huddle checklist was introduced, addressing team roles, expected physiology, and management plans. PDSA cycles incorporated guidelines and simulation-based education to improve confidence in specialized resuscitation strategies. Surveys were conducted at baseline and 6 months. Baseline, all-respondent confidence in managing "all types of CCHD" was somewhat confident (median 3/5; IQR 2-4) increasing to moderately confident (4/5; IQR 2-4) at 6 months (p = 0.59). Respondents with 0-3 years' experience showed increased confidence over 6 months in identifying unstable infants (from baseline 24% to 67% moderately/very confident, p = 0.005), prostaglandin E1 needs (from 24% to 62%, p = 0.013) and sedation requirements (from 5% to 33%, p = 0.045). Structured huddles improved confidence among less experienced team members, emphasizing the importance of shared mental models before CCHD deliveries.