title: Uncomplicated pregnancy: clinical pathway genesis based on the nursing process.
abstract: A prospective study of obstetrical patients from enrollment as outpatients until postpartum discharge was formulated at Madigan Army Medical Center. The control group included uncomplicated obstetrical patients from March 1 to August 31, 1994. The study group included uncomplicated obstetrical patients from March 1 to August 31, 1996. Patient satisfaction, identification of barriers to care, recognition of areas to improve quality of care, and cost-consequence analysis were studied. There were 1,042 control patients totaling 2,668 hospital days, with mean hospital stays of 2.56 days per patient (SD = 0.878). The study cohort comprised 1,050 patients with 1,965 hospital days, with a mean of 1.87 hospital days per patient (SD = 1.48). The study cohort demonstrated a statistically significant decrease (p < 0.05) in admission length of stay in the early discharge vaginal delivery gravidas, with cost savings from $3.2 million to $2.4 million. Using an interdisciplinary approach, we were able to elucidate the process necessary to identify critical nodes of patient care and satisfaction while providing significant cost savings.
authors.affiliation: Madigan Army Medical Center, Tacoma, WA 98431, USA.
authors.forename: C
authors.initials: C
authors.lastname: Brandsma
authors.forename: B C
authors.initials: BC
authors.lastname: Calhoun
authors.forename: J E
authors.initials: JE
authors.lastname: Vannatta
mesh_terms: D017046:Cost Savings; D019091:Critical Pathways / Q000191:economics; D005260:Female; D006801:Humans; D007902:Length of Stay; D008888:Military Nursing; D009736:Nursing Process; D009773:Obstetric Nursing; D010359:Patient Readmission / Q000191:economics; D017060:Patient Satisfaction; D011181:Postnatal Care / Q000191:economics; D011247:Pregnancy; D011446:Prospective Studies; D014481:United States