Redesigning induction of labour processes
| Autor: | Ashleigh Smith, Emma Paterson, Michael Beckmann |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Victoria Vaginal birth Personnel Staffing and Scheduling Cohort Studies 03 medical and health sciences 0302 clinical medicine Primary outcome Clinical Protocols Pregnancy medicine Humans Labor Induced 030212 general & internal medicine Birth time Retrospective Studies Morning 030219 obstetrics & reproductive medicine Obstetrics business.industry Pregnancy Outcome Obstetrics and Gynecology Prenatal Care Retrospective cohort study General Medicine Female business |
| Zdroj: | Australian and New Zealand Journal of Obstetrics and Gynaecology. 58:315-320 |
| ISSN: | 0004-8666 |
| DOI: | 10.1111/ajo.12734 |
| Popis: | Background An ‘in-hours’ birth represents a desired outcome following induction of labour (IOL) in terms of safety, efficiency and satisfaction. Women booked for IOL are often not commenced at their allocated times, and these sometimes complex births happen after-hours. Aims To measure the effect of an 11:00 hours commencement time for IOL. Materials and Methods A discrete-event-simulation patient-flow model was constructed. Multiple staffing and scheduling combinations were tested, before a brief pilot and subsequent introduction of a second IOL commencement time. A retrospective cohort study was performed using routinely collected data, comparing outcomes in two four-month time periods, before and after introduction of the new schedule. During Time Period A, women underwent cervical ripening at 19:00 hours and were reviewed the next morning for amniotomy and oxytocin infusion (ARM/oxytocin). During Time Period B, women were either admitted at 11:00 hours for cervical ripening followed by 23:00 hours ARM/oxytocin, or at 19:00 hours for cervical ripening followed by 06:00 hours ARM/oxytocin. The primary outcome measure was the likelihood of an in-hours birth (defined as 07:00–19:00 hours). Results In an analysis of 1689 women undergoing IOL, the new IOL booking schedule was associated with a 14.7% increase in in-hours birth (68.4% vs 53.7%; P |
| Databáze: | OpenAIRE |
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