OBGYN Hospitalist Program: The Increase in the Quality of Care by Adhering to Protocol-Driven Practices and Reducing Mistakes

Many hospitals are facing the same problems: Emergencies happen in Labor & Delivery with no physician present – bad outcomes lead to expensive malpractice costs Deliveries happen with no physician present, which stresses the nurses

Many hospitals are facing the same problems: 3. OBGYNs do not want to take call 4. There are unassigned patients 5. There may be midwives and family practitioners doing deliveries without backup No one wants to accept the transfer of high-risk patients

Many hospitals are facing the same problems: Patients wait a long time for evaluation Maternal Fetal Medicine specialists want to do an outpatient practice only and not come to the hospital No one wants to do vaginal births after cesarean section (VBACs) The cesarean section rate is too high

An OBGYN hospitalist program can help with all those issues Here is how it works…

Having a board-certified OBGYN physically present in Labor & Delivery They are there to respond to emergencies, start the emergency C-section They catch the baby instead of the nurse Make private practitioners happy by taking the call responsibility

Having a board-certified OBGYN physically present in Labor & Delivery Caring for the unassigned and high-risk patients Consulting for the family practitioners and midwives Evaluating patients promptly

Having a board-certified OBGYN physically present in Labor & Delivery Working collaboratively with the MFM specialist Encouraging VBAC by taking responsibility while the private practitioners stay in their office Studies prove that having professional full-time OBGYN hospitalists reduces the C-section rate.

In addition to solving those problems they also: Aid in retention and recruitment in both physicians and nurses Help fill up the beds in the neonatal ICU Increase patient satisfaction scores Unclog long wait times Aid in education of nurses (medical students and residents too) Increase compliance to protocols and new initiatives

But there’s a cost – All OBGYN hospitalist programs lose money So it costs about $1.5-1.75 million dollars per year (FILL IN YOUR PROGRAM ACTUAL COSTS HERE)

The direct revenue income is based on: Volume How many patient encounters Do the other practitioners ask for assistance at C-section? Do the private practitioners sign out to the hospitalists? Does the hospitalist see GYN patients in the main ED? Consultations from midwives and family doctors Transfer in of high-risk patients (and antepartum care working with maternal-fetal medicine specialists

The indirect revenue includes: Reduction in malpractice costs, not only to settle or pay but the cost to defend The increased money generated by the NICU bed occupancy The money saved by not having to do the expensive training of new Labor & Delivery nurses The increased volume of patients in the hospital generated by recruitment of new OBGYNs because of the hospitalist program Gaining new patients to the hospital attracted to the safety and efficiency / high patient satisfaction Not losing patients to competing hospitals because they have a better program

OB ED Potential new revenue comes from transforming outpatient Labor & Delivery triage evaluation to the OB emergency department This results in a modest increased professional fee but a substantial increase in the facility fee: An outpatient visit approximately $93 OB ED visit approximately $236 That could easily generate a million dollar increase in facility fee (FILL IN WITH YOUR OWN TRIAGE NUMBERS)

It’s the right thing to do for women and babies So we can’t measure an OBGYN hospitalist program by just P&L, we have to look at the wider benefits and minimize loss by doing an OB ED It’s the right thing to do for women and babies It makes your doctors and nurses happy and reduces their stress