Achieving Throughput in a High Volume Women's and Children's Center with a Multidisciplinary Approach

Holy Cross Hospital delivers over 9,000 babies a year.  Labor and Delivery was frequently backed up with delivered patients which impacted its capacity to accommodate scheduled C-sections, inductions, as well as, laboring patients.  A multidisciplinary approach was developed to facilitate throughput within the division.  Team members included representatives from all departments within the Women’s & Children’s Division with beds that could be used for delivered mothers/babies.  These departments were L&D, High Risk Perinatal Center (HRPC), Maternity Suites, Pediatrics and NICU. Also included were representatives from the Departments of Anesthesia, OB/GYN and NICU.  Ancillary departments such as Environmental Services and Transport were added later in the process.   A bed huddle was planned and implemented for all departments to discuss volume, bed availability and staffing resources. This huddle, based on the Quality Caring Model, is held on a daily basis with further plans to be held twice a day- AM & PM. This huddle takes place at the L&D Census Board .  Every department discusses their census, bed availability and staffing.  Decisions on bed placement and staffing resources are made at this time.  If in a high volume/high census time, an additional meeting will be called to evaluate  the established plan of the day and reevaluate if necessary and plan for the next day.  This approach has led to an increase in patient and staff satisfaction.