Uncomplicated pregnancy: Clinical pathway genesis based on the nursing process

A prospective study of obstetrical patients from enrollment as outpatients until postpartum discharge was formulated at Madigan Army Medical Center. T he control group included uncomplicated obstetrical patients from March 1 t o August 31, 1994. The study group included uncomplicated obstetrical patie nts from March 1 to August 31, 1996. Patient satisfaction, identification o f barriers to care, recognition of areas to improve quality of care, and co st-consequence analysis were studied. There were 1,042 control patients tot aling 2,668 hospital days, with mean hospital stays of 2.56 days per patien t (SD = 0.878). The study cohort comprised 1,050 patients with 1,965 hospit al days, with a mean of 1.87 hospital days per patient (SD = 1.48). The stu dy cohort demonstrated a statistically significant decrease (p < 0.05) in a dmission length of stay in the early discharge vaginal delivery gravidas, w ith cost savings from $3.2 million to $2.4 million. Using an interdisciplin ary approach, we mere able to elucidate the process necessary to identify c ritical nodes of patient care and satisfaction while providing significant cost savings.