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Re: Standing Room Only- triage strategies From: ainsron (ainsron@sbcglobal.net) Wed Oct 5 17:29:57 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: ainsron: "Re: Amenorrhea" Previous message: Garry E. Siegel, M.D.: "Gyn: Amenorrhea" In reply to: Garry E. Siegel, M.D.: "Re: Standing Room Only- triage strategies" Next in thread: rmodugno@aol.com: "Re: Standing Room Only- triage strategies" I'm at a small hospital, delivering physicians has increased from three to five with three CNMs, competition for beds is great, with 7 LDRPs. We do the same with prioritizing inductions. Sometimes the senior OB (me) has to be the "neutral arbitrator" to decide who goes first. Honesty and fairness are the key to running smoothly. Sometimes I have to bump myself also. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Wednesday, October 05, 2005 3:12 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Standing Room Only- triage strategies At a big (17K deliveries/year) hospital, all inductions are scheduled in advance unless acute, and the reason is stated. There are 3 tiers of groups as to why, i.e. first tier most important (42 weeks) and third tier least (i.e. 38 weeks, sister had C/S). Anyway, every day at 5:30 AM, the charge nurse looks at how many beds are open, and how many inductions are scheduled, and calls the patients in to L and D in order of severity/reason for induction. This requires all to be fair and tell the truth when posting inductions. . . Garry At Wed, 5 Oct 2005, JD Stewart,MD wrote: > >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 > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: ainsron: "Re: Amenorrhea" Previous message: Garry E. Siegel, M.D.: "Gyn: Amenorrhea" In reply to: Garry E. Siegel, M.D.: "Re: Standing Room Only- triage strategies" Next in thread: rmodugno@aol.com: "Re: Standing Room Only- triage strategies"

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