Implementation of a laborist program and evaluation of the effect upon cesarean delivery

Definitions of Obstetric and Gynecologic Hospitalists

“…Recent studies suggest these investments are warranted, because some research shows that obstetric and obstetric and gynecologic hospital medicine practices may reduce the risk of cesarean delivery, increase rates of vaginal births after cesarean delivery, and, as part of a comprehensive safety program, reduce adverse events and malpractice claims and payments. [12][13][14][15][16] The use of standardized definitions will clarify interpretation of these investigations. The Society of Obstetric and Gynecologic Hospitalists supports all efforts to improve the quality and safety of inpatient women's health care.…”

Impact of Obstetrician/Gynecologist Hospitalists on Quality of Obstetric Care (Cesarean Delivery Rates, Trial of Labor After Cesarean/Vaginal Birth After Cesarean Rates, and Neonatal Adverse Events)

“…12 Furthermore, the impact of laborist programs on cesarean delivery rates alone provide cost savings that pay for the implementation of these programs from the value they provide to the health care system. 30 …”

“…30 Importantly, this study concentrated on NTSV patients and used multivariate analysis for other obstetric factors affecting cesarean delivery rates. Moreover, Iriye and colleagues 30 showed the importance of examining the type of laborist program because no reduction in cesarean delivery was exhibited when a community laborist model was used. These investigators hypothesized that this finding could be expected for several reasons.…”

What is an Obstetrics/Gynecology Hospitalist?

“…[5][6][7] Comprehensive obstetric safety initiatives, which have included implementation of OB/GYN hospitalist programs at Yale University and New York Presbyterian-Weill Cornell Medical Center achieved substantial reductions in adverse outcomes, malpractice claims, and payouts on malpractice cases. 8,9 Additional components of these initiatives included the use of standardized protocols, obstetric safety nurses, anonymous event reporting, team training and electronic fetal heart rate monitoring certification, and cultural change led by the OB/GYN hospitalist.…”