Triage Versus Obstetric Emergency Department and Main Emergency Department: Best Practices

Historically, unscheduled patients were evaluated on labor and delivery via a traditional triage model that involved a nurse evaluating the patient and corresponding with the responsible clinician over the phone. This method was not standardized and made labor and delivery the only location in the hospital where patients would present unscheduled and not be seen by a qualified clinician on a consistent basis. It has been shown that having a provider in the hospital available to see and evaluate every patient in a timely fashion improves care and patient satisfaction. A model is considered best practice when it requires standardized, consistent, timely evaluation and care by a qualified clinician every time. The OBED allows for these elements and confirms the ability to bill and be reimbursed in alignment with emergency room charges which are more appropriate for the resource allocation required for this kind of care. Obstetric hospitalists are present in the hospital, trained and experienced in management of obstetric emergencies and therefore uniquely poised to provide this care in collaboration with frequent communication with main emergency room staff. The Society for OB/GYN Hospitalists has taken this one step further, developing a core competency delineation around the role an obstetric hospitalist plays in the OBED/triage.8 8 There are many elements to be considered when implementing an obstetric ED. With forward planning and collaboration with stakeholders in the emergency, IT, nursing and physical plant departments, a successful conversion from triage to OBED can occur.