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Re: Standing Room Only- triage strategies From: rmodugno@aol.com Thu Oct 6 15:25:32 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: Amenorrhea" Previous message: rmodugno@aol.com: "Re: Standing Room Only- triage strategies" In reply to: Anna Meenan, MD: "Re: Standing Room Only- triage strategies" Next in thread: Anna Meenan, MD: "Re: Standing Room Only- triage strategies" Reply: Anna Meenan, MD: "Re: Standing Room Only- triage strategies" Anna, as someone who would want their epidural in the parking lot and who spent a full week in the hospital recovering from inguinal hernia surgery at the tender age of 18 - I sympathize with you . The real problem is bed occupancy. When the managed care companies kicked sections out at 48hours - there was no problem. With increasing section rates, postpartum is full and it bottlenecks all the way back through L&D converting our LDR's into LDRP's and preventing us from bringing in our elective inductions! ;+) Robert Modugno MD MBA FACOG Marietta, GA -----Original Message----- From: Anna Meenan, MD <annam@uic.edu> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> Sent: Thu, 6 Oct 2005 12:29:50 -0500 Subject: Re: Standing Room Only- triage strategies Gee, a woman with a fresh abdominal incision who may have spent the previous 12-24 hours contracting every 3 minutes with no sleep is "taking advantage" of a 4-day recuperation. Most of our pts go home on the third day after a c-section, but I still remember being kept 7 days after an emergency oophorectomy when I was 21, and I barely felt ready to go home then (and i didn't have a baby who was going to wake me every three hours once I got home). -- Anna Meenan, MD At Thu, 6 Oct 2005, Myer S. Bornstein wrote: > >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 > Next message: Garry E. Siegel, M.D.: "Re: Amenorrhea" Previous message: rmodugno@aol.com: "Re: Standing Room Only- triage strategies" In reply to: Anna Meenan, MD: "Re: Standing Room Only- triage strategies" Next in thread: Anna Meenan, MD: "Re: Standing Room Only- triage strategies" Reply: Anna Meenan, MD: "Re: Standing Room Only- triage strategies"

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