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Improving Satisfaction with Care and Reducing Length of Stay in an Obstetric Triage Unit Using a Nurse‐Midwife‐Managed Model of Care
Author(s) -
Paul Julie,
Jordan Robin,
Duty Susan,
Engstrom Janet L.
Publication year - 2013
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/j.1542-2011.2012.00239.x
Subject(s) - triage , medicine , patient satisfaction , likert scale , unit (ring theory) , medical emergency , emergency medicine , nursing , psychology , developmental psychology , mathematics education
A quality improvement project was initiated at a tertiary‐care center in a suburban area of the northeastern United States to determine whether length of stay and patient satisfaction in an obstetric triage unit could be improved by using a certified nurse‐midwife (CNM) to manage and organize care in the triage unit. Methods Patient satisfaction was measured using a previously validated instrument that consisted of 6 items using a 6‐point Likert‐type scale. The items measured patient satisfaction with: wait time for provider, information given, amount of time spent with provider, length of visit, overall care received, and overall triage experience. Patient satisfaction was measured before (n = 37) and after implementing CNM‐managed care (n = 66) in an obstetrical triage unit. Length of stay in the triage unit was measured during standard care (n = 121) and after the implementation of CNM‐managed care (n = 151) by recording the number of minutes women spent in the triage unit. Results Participants in the CNM‐managed care group reported increased patient satisfaction with care in 5 of the 6 aspects of satisfaction that were measured, including wait time for provider ( P = .01), time spent with provider ( P = .01), length of visit ( P = .04), overall care received ( P = .04), and overall triage experience ( P = .01). The length of stay was significantly shorter for the women in the CNM‐managed group (mean = 94.7 minutes; standard deviation [SD] 50.1) than for the women in the standard care model (mean = 122 minutes; SD = 66.8; P < .01). Discussion The findings from this project suggest that a CNM‐managed obstetric triage unit can improve satisfaction with care during the triage experience and reduce length of stay in the triage unit.