title: The development and implementation of normal vaginal delivery clinical pathways in a large multihospital health system.
abstract: The entire country has become more concerned with healthcare costs due to managed care, capitation risk-based contracts, and the near elimination of the cost-plus reimbursement system. Clinical pathways have become one way to reduce unnecessary resource consumption by reducing provider variance, improving clinical outcomes, and reducing cost. We present here our rationale and process for developing a common clinical pathway for normal vaginal delivery in a large and varied multihospital system. We also discuss how this new pathway is expected to improve quality of care and reduce costs.
authors.affiliation: Department of Obstetrics and Gynecology, Detroit Medical Center, Wayne State University School of Medicine, MI 48201, USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Ransom
authors.forename: S G
authors.initials: SG
authors.lastname: McNeeley
authors.forename: A
authors.initials: A
authors.lastname: Yono
authors.forename: J
authors.initials: J
authors.lastname: Ettlie
authors.forename: M P
authors.initials: MP
authors.lastname: Dombrowski
mesh_terms: D019091:Critical Pathways; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D007902:Length of Stay; D008824:Michigan; D009096:Multi-Institutional Systems / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D019982:Organizational Case Studies; D018743:Perinatal Care / Q000592:standards*; D010865:Pilot Projects; D011181:Postnatal Care / Q000592:standards; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards; D017064:Process Assessment, Health Care