title: Improving satisfaction with care and reducing length of stay in an obstetric triage unit using a nurse-midwife-managed model of care.
abstract: BACKGROUND
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Julie.Paul@frontier.edu
authors.forename: Julie
authors.initials: J
authors.lastname: Paul
authors.forename: Robin
authors.initials: R
authors.lastname: Jordan
authors.forename: Susan
authors.initials: S
authors.lastname: Duty
authors.forename: Janet L
authors.initials: JL
authors.lastname: Engstrom
mesh_terms: D000328:Adult; D002568:Certification; D005260:Female; D006757:Hospital Units; D006801:Humans; D007902:Length of Stay; D008427:Maternal Health Services / Q000458:organization & administration* / Q000592:standards; D008880:Midwifery; D016294:Models, Nursing; D009511:New England; D009721:Nurse Midwives; D017060:Patient Satisfaction; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration* / Q000592:standards; D058996:Quality Improvement; D059039:Standard of Care; D013383:Suburban Population; D062606:Tertiary Care Centers; D014218:Triage