Decreased waiting periods in a public pregnancy termination clinic.
BACKGROUND
In our public hospital, first-trimester pregnancy termination historically had been performed in an operating room by suction curettage on a separate day following the initial clinic visit. To increase efficiency, we instituted three changes over a 2-year period: (a) pregnancy termination procedures were relocated to the outpatient area; (b) same-day service was initiated; and (c) manual vacuum aspiration was introduced. Our primary objective was to assess the effects of these changes on the waiting period in days from the intake visit to the day of termination procedure. Our secondary objectives included assessing any decrease in gestational age at the time of procedure, increases in the numbers of procedures at <9 weeks, the numbers of procedures per session and the proportion done on the day of intake.


METHODS
This is a retrospective cross-sectional review of the clinical records of patients who requested pregnancy termination. Data were obtained on 625 patients who underwent a surgical termination of pregnancy from February 1, 2004, to January 31, 2006.


RESULTS
The waiting period decreased from 20.3 to 3.6 days (p<.01), and mean gestational age at termination decreased from 11 to 9 weeks (p<.01). The proportion at <9 weeks' gestation increased from 1.7% to 40% (p<.01). The number of procedures per session increased by 52.7% (p<.01). The percentage of same-day procedures increased from 7% to 62%.


CONCLUSIONS
We improved efficiency of care by reducing the waiting period and terminating pregnancies earlier in gestation with manual equipment.
Patel
Ashlesha
A
Division of Family Planning, Department of Obstetrics and Gynecology, John H Stroger, Jr Hospital of Cook County, Chicago, IL 60612, USA. ashleshapatel16@yahoo.com
Panchal
Hemang
H
Patel
Rupesh
R
Keith
Louis
L
D000028:Abortion, Induced / Q000379:methods*; D000029:Abortion, Legal / Q000379:methods*; D002641:Chicago; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D010044:Outpatient Clinics, Hospital; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D013997:Time Factors; D014619:Vacuum Curettage / Q000379:methods*; D014850:Waiting Lists