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Rae Charos, DNP, RN
Chief Nursing Officer, St. Joseph’s Medical Center

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OB-ED Establishment Improves Hospital Core Measures

Case Studies

OB-ED Establishment Provides Growth at St. Joseph’s Medical Center

Hospital Information

Facility: St. Joseph’s Medical Center in Stockton, CA

Labor & Delivery Patient Volume: 2,500+ Annual Deliveries

TeamHealth Services: OB-ED and OB Hospitalist Services

Challenge

  • St. Joseph’s Medical Center has served the health care needs of the residents of Stockton, California for more than a century. Among other areas of specialization, the hospital is recognized for women’s and children’s health. Housed in a beautiful Pavilion, the Labor and Delivery area sees nearly 3,000 births annually and the 30-bed Neonatal Intensive Care Unit provides care for high-risk infants.
  • As the city’s population has grown, so have the demands on St. Joseph’s obstetrical services:
  • Growing number of unassigned patients seeking treatment for obstetrical emergencies
  • Increased stress on Labor and Delivery nursing staff to perform initial health assessments of women with obstetrical emergencies, then coordinating care with obstetricians on the hospital medical staff, often via phone
  • Inability to perform Trial of Labor after Cesarean deliveries
  • Inability to charge for health assessments and other services provided by nurses
  • Growing demands from obstetricians on the medical staff for improved work/life balance related to taking coverage, especially on nights, weekends and holidays
  • Increased demand due to the sudden closure of a competing OB program
  • An agreement with Kaiser Permanente which allowed its members to access OB services at St. Joseph’

Solution

Before the spike in its OB business, the leadership team at St. Joseph’s had begun implementing a strategic plan to address some of the challenges it was facing. The first step was to identify a strategic partner to provide a coverage and staffing solution for OB services. After a thoughtful search, the hospital selected TeamHealth because of its comprehensive approach to OB. In addition, TeamHealth was already partnering with St. Joseph’s so they could benefit from the added value to be derived from the integration of key clinical service lines.

An assessment by the TeamHealth OB experts revealed the need for an OB hospitalist program to meet coverage and staffing challenges and the value of establishing an OB-ED to safely care for the growing volume of pregnant women seeking care for emergent issues. The OB triage area, located adjacent to Labor and Delivery on the first floor of the Pavilion, was quickly converted into an OB-ED. The OB hospitalists seamlessly assumed responsibility for the surge of unassigned patients and patients of private obstetricians on the medical staff who sought treatment after hours or on holidays. Education and communication with obstetricians on the medical staff was critical to the speedy acceptance of the OB hospitalists and the OB-ED.

Results

By partnering with TeamHealth’s OB services, St. Joseph’s has successfully integrated the OB hospitalists and OB-ED into its overall OB operations. Hospital leadership is pleased with results that include:

  • Significant increase in OB volume to nearly 3,000 births per year
  • 24/7 OB hospitalist coverage has improved nursing satisfaction, resulting in higher OB nurse retention and increased nurse engagement
  • Improved OB patient satisfaction scores with the availability of an OB hospitalist around the clock, reducing wait times and length of stay
  • Fewer return visits within 24 hours by OB patients who came to the hospital seeking treatment for emergent issues
  • Improved OB physician satisfaction scores due to enhanced work/life balance from OB hospitalist program
  • Improved coordination between hospital ED and OB-ED for pregnant women presenting with emergent health issues
  • Greater peace-of-mind for hospital administration with increased clinical quality and patient safety and convenience for OB patients

“TeamHealth’s obstetrics team is knowledgeable, available and very responsive. Increased physician coverage resulting from the OB hospitalist program and establishment of the OB-ED to safely care for pregnant women’s emergent health issues are the biggest benefits of our partnership with TeamHealth.”

For more information about TeamHealth’s OB hospitalist service, or to learn more about the benefits of establishing an OB-ED call 800.818.1498 or email us at business_development@teamhealth.com.

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