Induction/c-section scheduling

[dnellnelson]

I need input on how to limit or not limit scheduled procedures. These include inductions, c-sections, BTLs, and cerclages. We even occassionally schedule Baby Eye laser procedures. We deliver about 250/month. We have 12 LDRs, 3 ORs, and a 30 bed postpartum unit(it is staffed separately) We currently have 8 timeslots for inductions(12 MN,5:30a,7:30a, 9:30a) However, we limit the total inductions to 6. Surgeries are not limited in number. Some docs want to schedule every thing in 2 days (usually Thur and Fri). We are then busting at the seams and then if Postpartum gets backed up we have to hang on to our delivered patients and have no LDRs for new admits. It really is mass chaos. I just wanted to know what other similar facilities do.

[fourbirds4me]

We do about 90-100 deliveries/month. We have a policy that is about 6 months old now that limits procedures to 3/day. So whether it is c-section, induction or whatever.... 3/day. Dr's much schedule w/ the charge nurse who then writes it in the book.

Problem with this is all inductions start at 0600 (Dr's like to deliver before they go home at 5:00. So that can get a bit crazy at times. Usually if they havn't made good progress by about 7:00pm on call usually starts talking c-section.

[way2go]

We worked with the Medical OB Department Committee to develop general guidelines (limiting the # any one MD could book in one day, then they developed "triage" guidelines to "bump" cases when more urgent medically indicated cases needed to be done). We are a 12 bed LDR, and book 4 cases per day, plus NST's. It took about 6 months for all of the acting out to stop, but runs very smooth now. Hopefully you have a good relationship w/your OB Dept. Chair. In the long run, it keeps their sch. cases from gettng cxl'd due to bed availablity and staffing.

[SmilingBluEyes]

Need to do as above people said, and have a POLICY in place limiting scheduled procedures....espeicially ELECTIVE ones. That is what we do...based on staffing availability, we usually spread them out thru the day/eve and usually only 2 csections plus 1 indx a day...or 2 indx plus one section. We usually admit cytotec indx on the nightshift, pit indx at 0600. we then do csections at around 0800 and 1200-1300.

We do about 70 deliveries a month, are an LDRP unit, meaning we staff for it all....and we also take care of post-op GYN surgical patients. So clearly, WE HAVE TO SET LIMITS on how many procedures a day can be scheduled. Unless there is an urgent need, we don't allow more than this and once the day is "booked" we highlight it as such.

Hope this helps.