To analyze the effects of strenuous implementation of a labor dystocia checklist on NTSV patients and its impact on hospital charges. This was a retrospective cohort study performed at an academic community hospital. Maternal peripartum and newborn hospital charges were tabulated and compared between twenty months prior to and following implementation of a labor dystocia checklist based on the OCC Labor Dystocia Guidelines. Exemplar itemized hospital charges for daily maternal and newborn care, and delivery were acquired from the billing department. Individual charges were averaged between the two epochs to adjust for inflation. Our hospital charges are comparable to national data in 2014 available from the U.S. Department of Health and Human Services’ Agency of Healthcare Research and Quality. A total of 466 NSTV charts were reviewed with 263 women delivering from January 1, 2014 to September 30, 2015 and 203 women delivering from October 1, 2015 to May 31, 2017. A 28% NTSV Cesarean rate decrease was observed after introduction of a labor dystocia checklist on October 1, 2015. Maternal mean length of stay (LOS) during labor increased by 0.2 days/patient and postpartum LOS decreased by 0.1 days/patient. Mean NICU admission decreased by 49.6% and 8.1 days/patient. Hospital charges for labor, postpartum, newborn and NICU care and either Cesarean or vaginal deliveries were applied, as appropriate. Integrated average maternal and neonatal charges per maternal labor admission prior to checklist were $47,760.58 and after were $28,668.65. There was no significant difference in maternal or neonatal morbidity. Decreasing NTSV Cesarean deliveries through the OCC guideline resulted in substantial financial benefits.View Large Image Figure ViewerDownload Hi-res image Download (PPT)