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OB Challenges Create Hospital Opportunities in 2008

Industry Consulting Firm Highlights Key Issues and Offers Suggestions on

Improvements for Hospital Administrators

NEW YORK, March 31 /PRNewswire/ -- For expectant parents, choosing the right hospital for the delivery of a baby is a significant decision. But there are many things that go on behind the scenes in obstetric departments around the country that must function properly in order to ensure a positive patient experience and a healthy newborn. Through its work in hospitals and health facilities nationwide, management consulting firm, Tefen, has identified a "Top 10" list of issues poised to impact the obstetrics space this year.

"In 2006, there were over 4.2 million births in the U.S.*, and by the end of 2008, the national cesarean birth rate is expected to approach 35% and to nearly 50% in some places," explains Barry Calogero, president of Tefen USA. "Changes are happening to how women are giving birth, and hospitals must adapt to these shifts. What happens in the OB departments can ultimately impact a facility's cost, quality and access. Administrators need to focus their attention on these trouble spots and devise tangible, sustainable solutions."
Tefen highlights the following OB areas requiring attention:

1. Procedure scheduling: Although more patients arrive in a scheduled

fashion, the way in which C-sections and inductions are scheduled

cause artificial 'peaks and valleys' -- both in the time-of-day and

day-of-week. The hospital then faces patient boarding in labor and

delivery units, staffing issues and overcrowded mother and baby


2. Active discharge management: Many OB programs are lacking clear

visibility on which patients are ready for discharge. Procedures,

such as circumcision, newborn hearing and other tests and tasks, such

as issuing a birth certificate often contribute to the delay in

discharge. These tasks, when handled proactively and in a timely

manner, can alleviate the discharge process.

3. Facility sizing: Many hospitals that are planning expansions or

remodeling of their facilities may benefit by implementing Process

Improvement procedures prior to breaking ground. This can help

hospitals identify ways to enhance practices before construction.

Evaluating areas like patient satisfaction, optimal sizing for the

operation (to incorporate Lean principles) and considering ways to

reduce staffing costs for the lifecycle of the new building are all

areas that should be explored thoroughly before an expansion.

4. Forecasting: OB programs have the ultimate insight to volume

forecasting. Although hospitals cannot predict the exact date for a

patient's arrival, delivery due dates provide rough estimates. These

time frames can then be used to plan for volume peaks and valleys

when the woman is in the triage, Labor & Delivery and postpartum


5. Provider practice patterns: Variation in practices, such as looking

at indications and methods for inductions and elective C-sections

impact the utilization and flow of hospital resources. By instilling

guidelines, hospital administrators and medical directors can impart

a more standardized process that will help them better plan.

6. 'Pull systems' for patient transfer: Patients are often required to

wait in hallways and other areas until they can be moved to an

available bed in the next point of their journey. Introducing pull

systems enforces the accountability of the receiving unit, reducing

boarding time between the Labor & Delivery and postpartum periods.

7. Housekeeping room turn-around time (TAT): When rooms become

available, quick turnaround times can help alleviate capacity

constraints. Applying communication improvements, coupled with Lean

principles such as Single Minute Exchange of Die (SMED) can help

achieve low TATs.

8. Supply Management: "A place for everything and everything in its

place" is a phrase that applies greatly to OB departments. Staff

needs necessary supplies and materials at their fingertips, without

having to searching for a missing item or sort through excess

material to find what is needed. Applying Lean principles can help

and ensure all Labor & Delivery suites, as well as supply rooms are

stocked in a standardized manner.

9. Staff leveling: With the rationalization of scheduled deliveries, OB

departments have the opportunity to optimize staffing levels to match

demand by time of day and day of week.

10. Information system infrastructure and key performance indicators: OB

departments are rich in data. Leveraging this information can help

them better support appropriate decision-making for operational


By evaluating all of these factors and moving forward proactively to address them, Tefen believes that OB departments will be better able to consistently set and manage expectations and satisfaction of both staff and patients. "Increasing the process visibility and opening channels of communication can help facilities address many of its needs," explains Calogero. "If OB administrators commit to monitoring progress and driving forward continuous improvement, they may not only improve on cost, quality and access but can also use operational improvements in the OB space as a model for change in the hospital as a whole."

About Tefen

Tefen Ltd. is a leading international management consulting firm that specializes in helping organizations achieve performance excellence. Since its founding in 1982, the company has served some of the world's largest and fastest growing businesses, while acquiring a strong reputation as a cost efficient, nimble consulting partner. From strategy through to implementation, Tefen creates value by optimizing the competitiveness, reliability, and agility of its customers. With its hands-on approach philosophy, the firm has achieved tremendous success in delivering quantifiable and value-driven results. Headquartered in Israel and employing over 300 consultants worldwide, Tefen also has offices in Europe and in the United States.

About Tefen USA

Tefen USA is a subsidiary of Tefen, a global management consulting firm founded in 1982. The company focuses on driving performance excellence to achieve improvements in cost, quality, and service delivery. Tefen USA supports a variety of industries and has worked with many Fortune 500 organizations. Tefen partners with clients to build quantified cases for change, setting themselves apart by working with clients from strategy through implementation to achieve sustainable results.

* CDC National Center for Health Statistics, Births: Preliminary Data for 2006.


Yvonne Liu Melissa Connerton

Tefen USA CooperKatz & Company for Tefen USA

646-652-8275 917-595-3039

Copyright©2008 PR Newswire.
All rights reserved

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