The birthing center at a large teaching hospital was facing challenges on numerous fronts: overcrowding, losing share to a competitor, and an aging infrastructure. To improve the patient experience, the hospital wanted to provide private labor and delivery rooms to all families while at the same time addressing overcrowding.
Catalyst compiled staff members’ key concerns, informing which analyses needed to be conducted to support future discussions and decision processes. After setting the priorities, we used utilization heat maps, Tableau, and Excel to help the hospital visualize its current utilization and opportunities for improvement. Catalyst then interviewed personnel from various departments that work with obstetrics (such as environmental services, security, and facilities) to get their perspectives on operational challenges.
Review of the data found several operational inefficiencies. For example, operational practices and physician practice patterns needed to be reviewed and revised to optimize operational efficiencies. Variations in shift lengths by job (eight- versus 12-hour shifts) resulted in inefficiencies in work flow, reporting, and patient care. Space constraints also contributed to inefficiencies and inconsistencies throughout the department.
Hospital leadership wanted a new operating room in the department. Review of heat maps found that both the PACU and OR had very low utilization across all rooms, with an unusually high spike in procedures occurring consistently on Fridays. Catalyst suggested investigating why OR use was so high on Fridays as well as adopting scheduling standards and criteria to improve efficiencies rather than build a new OR.
Key to improving the patient experience was increasing the number of private rooms. Data found that 57% of patients were moved from a semiprivate bed to a private location because of dissatisfaction, and some patients were moved multiple times. This practice caused bottlenecks in admissions and additional work from housekeeping to support room turnover. Catalyst recommended reducing the number of semiprivate beds by unofficially designating these rooms as “private” to decrease both patient movement and staff workload.
However, with LDR utilization at 70-80%, operational improvements would not address all capacity issues. Because we recommended against building a new OR, we also suggested the capital could be spend on adding private rooms.
Catalyst provided utilization reports and root cause analyses to explain why the hospital was experiencing bottlenecks and helped them develop best practices for managing utilization challenges. Increasing the capacity of the hospital’s birthing center allowed the labor and delivery staff to provide high-quality care with patient safety at the forefront. Ultimately, Catalyst’s solutions bought the hospital some time until it could build more LDRs, allowing it to improve patients’ stays.