THE PROBLEM OF DELAYED DISCHARGE IN LABOR AND DELIVERY

摘要

Enloe Medical Center is a non-profit community hospital in Chico, California. Among the many services they provide is a Labor and Delivery Department. While mothers are routinely admitted from 1:00pm to 1:00am, they are generally discharged between 10:00am and 5:00pm. This results in a generic bell curve behavior pattern for patient occupancy during the daytime. Hospitals are reimbursed for inpatient services in two major ways: either on a per diem basis, or by diagnosis related groups (DRG). Either way, the revenue to the hospital remains the same, regardless if the patient is discharged at 4:00am or 4:00pm. In California, state mandated nurse to patient ratios require hospitals to maintain a minimum level of nurse staffing for inpatient services. Thus, as the patient census rises during the day, so must the number of nurses on staff. This is the problem studied; costs expended for patient discharge delays.