Organisational Environment

The labour room lacked current common intrapartum care guidelines, and care was largely based on consultants’ individual plans. Resource constraints pushed available capacity toward direct patient care and away from medication safety work. Siloed management structures weakened shared responsibility and interprofessional coordination for MMU safety. Insufficient healthcare resources were the most significant organisational barrier to physician participation. Organisational barriers included management gaps, workload, physical resource problems, insufficient training, and lack of updated guidelines. Management gaps included poor supervision, inadequate support, lack of appreciation, inadequate supplies, and weak feedback systems. High patient load increased workload and reduced quality of care. Unclear task and responsibility division was a major organisational challenge. Inadequate space prevented labour companionship because privacy could not be ensured. Heavy workload caused stress and reduced individual attention to women.