Re: Standing Room Only- triage strategies

From: Myer S. Bornstein (mborn@massmed.org)
Thu Oct 6 11:34:55 2005


State law mandates 4 day stay after C/Section and patients take advantage of this. Myer

--
Myer S. Bornstein, MD, MMM, FACOG, FACPE
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod
Darryl G MAJ 48 MDOS/SGOBO
Sent: Thursday, October 06, 2005 3:10 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Standing Room Only- triage strategies

I'm only curious why you say that elective c/s stay longer? I can't tell you the last time an elective c/s of mine didn't go home 48 hours after the baby was born. Without labor prerequisite, the composite time in the hospital has been less.

Just my thoughts

Glen

-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of JD Stewart,MD Sent: Wednesday, October 05, 2005 8:09 PM To: Multiple recipients of list OB-GYN-L Subject: Standing Room Only- triage strategies

Facing an acute bed shortage in L&D/ postpartum/ nursery and postop GYN surgery all at the same time due to hospital remodeling. Figure this has come up everywhere at one time or another, and I was curious as to the ways this may have worked out...Elective induction rate now >50%; <2% VBAC's in state, so repeat C/S rate is way up (with longer stays)..and most of the groups here now no longer throw all the OB delivery income into a common pool, but link it to the delivering partner- so the motivation to electively admit and deliver on "Dr X's hospital day" is tremendous.

Push has come to shove, and we are now facing the "medical ante-up" game for line jumping on the induction list. ("..38 weeks plus Short stature/small feet...and her sister had an emergency C/S and is worried.." )

Wondering if anyone faced with this has a handy common sense priority strategy they might share...

--
JD. Stewart, MD
MFM up too late all night, every night




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