PROJECT: Increase the hospital's vaginal birth after C-section (VBAC) rate by guaranteeing compliance with ACOG's 30-minute standard. PRINCIPALS: OB and OR nursing staff and physicians, and the director of laboratory services. Process Improvement Method: Plan-Do-Check-Act. Timeline: January 1991-July 1992. KEY FINDINGS: Lack of physician confidence in the hospital's system for handling emergency C-sections resulted in fewer trials of labor for women with a history of previous C-section. 70 percent of delays involved patient preparation for surgery, OR setup, or patient transport. Laboratory delays, not previously identified as a problem, in fact, were one of the root causes of delayed emergency C-sections. RESULTS: By performing tests in advance, lab time has dropped from 11 minutes to zero. Patient prep time has dropped from 9 minutes on average to 2.8. 88 percent of emergency C-sections have met ACOG's 30-minute guideline.
PROJECT: Increase the hospital's vaginal birth after C-section (VBAC) rate by guaranteeing compliance with ACOG's 30-minute standard. PRINCIPALS: OB and OR nursing staff and physicians, and the director of laboratory services. Process Improvement Method: Plan-Do-Check-Act. Timeline: January 1991-July 1992. KEY FINDINGS: Lack of physician confidence in the hospital's system for handling emergency C-sections resulted in fewer trials of labor for women with a history of previous C-section. 70 percent of delays involved patient preparation for surgery, OR setup, or patient transport. Laboratory delays, not previously identified as a problem, in fact, were one of the root causes of delayed emergency C-sections. RESULTS: By performing tests in advance, lab time has dropped from 11 minutes to zero. Patient prep time has dropped from 9 minutes on average to 2.8. 88 percent of emergency C-sections have met ACOG's 30-minute guideline.