Transforming Obstetric Triage Into an Obstetric Emergency Room

Abstract

Proposed Change To create a new system in which obstetric patients would be seen in the emergency room (ER). Typically pregnant women who were at 20 weeks gestation or greater were sent to the obstetric (OB) unit for evaluation in triage. If the condition was not pregnancy related, the woman was moved to the ER after the fetus was evaluated. The new system allowed for the woman to be seen in the ER as the OB triage area was transformed into an OB ER. The billing and reimbursement reflected this change as well. Implementation, Outcomes and Evaluation A multidisciplinary team, including ER physicians and nurses, OB physicians and nurses, compliance, revenue cycle management, legal staff, and other key stakeholders evaluated the process and wrote a new policy that guided where pregnant women should be seen in the ER. Women in the outpatient clinics also were educated as to where to present for various conditions. This resulted in fewer women waiting to be seen in the OB ER for nonobstetric issues and no women being sent to the ER from the OB ER for further evaluation, which increased patient satisfaction. The revenue for triage visits was increased by $365K per quarter.