Impact of an Obstetrical Hospitalist Program on the Safety Events in a Midsized Obstetrical Unit [24N]

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Abstract

INTRODUCTION:

As internal medicine hospitalist programs were developed to address issues in medicine such as a need to improve quality, improve efficiency and decrease healthcare cost, obstetrical (OB) hospitalist models were developed to address needs specific to obstetrics and gynecology (OB/GYN). Though there is an increase of OB hospitalist model utilization in the U.S., there is currently no published studies available that report outcomes following the implementation of OB hospitalist programs. Our objective was to compare outcomes measured by occurrence of safety events prior to and after implementation of an OB hospitalist program in a mid-sized obstetrical unit.

METHODS:

Our regional obstetrical referral hospital has approximately 3500 deliveries per year. Safety events are regularly monitored and evaluated. Our full-time OB hospitalist program was implemented in October 2014, with continuous coverage of the labor and delivery (L/D) floor. Safety events from the pre-implementation period, July 2012-September 2014, were compared to the post-implementation period, October 2014-June 2016.

RESULTS:

From July 2012 through September 2014, 11 safety events occurred on the L/D floor. From October 2014 through June 2016, post-implementation, there was zero safety events associated with L/D.

CONCLUSION:

Full-time OB hospitalists provided patients with immediate evaluation, early recognition of critical clinical events, and provided management in high stakes clinical situations. While it has been speculated that implementation of an OB hospitalist model would be associated with improved maternal and neonatal outcomes, our regional obstetrical referral hospital demonstrated a significant decrease and elimination of obstetrical safety events following the OB hospitalist program implementation.

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