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///2010 Abstract Details
2010 Abstract Details2019-08-03T15:49:10-05:00

Daily Distribution of Deliveries in Two Labor and Delivery (L&D) Suites at An Academic Medical Center

Abstract Number: 105
Abstract Type: Original Research

Josue Rivera BS, MS1 ; Pamela Flood MD2; Vanessa E Hennig-Roshong 3; Shelby H Davies 4; Gregory V Hebert BS5; Richard M Smiley MD, PhD6

For economic and organizational reasons, interest exists in describing and potentially controlling anesthesiology workload. Almost all of this analysis has focused on operating room efficiency [1-3]. Little data exists describing work patterns in L&D units; a recent letter described Cesarean(C/S) and total delivery patterns by day of the week at one institution [4]. We examined the daily pattern of cesarean (CS) and vaginal (VD) deliveries in the two L&Ds served by our anesthesia service in order to describe the daily workload pattern and note any predictable differences in delivery patterns between different types of L&D. In this abstract we present the data for vaginal, cesarean, and total deliveries by day of the week.

METHODS: This study utilized data gathered in two L&D Suites covered by the Departments of Ob/Gyn and Anesthesiology of our university medical center. One is an "academic" high-risk tertiary referral labor suite with ~4500 deliveries annually (designated ACAD), and the other is a low-risk "community" obstetric service with ~2400 deliveries (COMM), located about 3 miles from the main campus. The delivery time for every CS and VD in both locations for the entire year 2008 were entered into an electronic database. Variables collected included: gravidity, parity, obstetrician, date/time of delivery, delivery type (CS, NSVD, or instrumental vaginal), and type and time of anesthetic intervention. Daily delivery numbers (mean 95 CI) were determined for each L&D Suite and compared by ANOVA. Comparison between ACAD and COMM were made by normalizing the raw numbers by the totals deliveries at each site and then an unpaired t-test comparing the total for same days at each site.

RESULTS: There were obvious differences in delivery numbers between weekdays and weekends, as would be expected (Figure). There are apparent differences between the two practice sites; e.g., on a normalized basis, there are more total Saturday deliveries at COMM than ACAD, and more Monday and Tuesday deliveries at ACAD (p < 0.005) but no differences between totals on the other days.

CONCLUSIONS: Analysis of L&D delivery patterns has rarely been done. Analysis of the timing of deliveries may reveal patterns that can inform staffing decisions or suggest effects of clinical management strategies and/or patient populations.

REFERENCES: 1.Anesth Analg 2001;92:1493-8; 2.Anesth Analg 2006;102:1491-500; 3.Anesth Analg 2006;103:1499-516; 4.Anesthesiology 2008;109:161-2

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