Qualitative Analysis of Challenges Managing Staff and Bed Availability on Labor and Delivery Units [34E]. (May 2018)

• Record Type: Journal Article
• Authors: Plough, Avery; Henrich, Natalie; Galvin, Grace; Shah, Neel T.
• Is Part Of: Obstetrics and gynecology. Volume 131(2018)Supplement 1
• Publication Date: 2018-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000533053.51847.c2
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Mangers of labor and delivery units need to ensure that their limited supply of beds and nursing staff are adequately available, despite uncertainty regarding future patient needs. The ability to address this management challenge has been associated with patient outcomes, however best practices for managing labor and delivery unit resources have not been defined. METHODS: We conducted a secondary analysis of 96 interviews with nurse and physician managers from 48 labor and delivery units across the United States. Based on emerging themes, we identified common challenges in managing bed and staff availability. For each management challenge, we assessed specific management practices based on proactiveness (ability to mitigate challenges before they occur) and systematicness (ability to address challenges in a consistent and reliable manner). RESULTS: We identified four key challenges common to all labor and delivery units: 1) scheduling planned cases, 2) tracking patient flow, 3) monitoring bed and staff availability in the moment, and 4) adjusting bed and staff availability in the moment. We observed that proactiveness and systematicness represented distinct characteristics of management practices with some units exhibiting proactiveness but not systematicness and vice versa. Units with both proactive and systematic practices appeared best positioned to reliably address resource challenges effectively. CONCLUSION: Labor and delivery unit managers should assess both the proactiveness and systematicness of their existing resource management practices and consider how their practices could be modified to improve operations and quality of care.