Pain Control in the Laboring Patient Dr John Gianopoulos MD Dr Ku-mie Kim MD Sandra Swanson RN MSOD Maureen Davey RNC Denise Goray RN BSN.

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Presentation transcript:

Pain Control in the Laboring Patient Dr John Gianopoulos MD Dr Ku-mie Kim MD Sandra Swanson RN MSOD Maureen Davey RNC Denise Goray RN BSN

Project Aim Statement Reduce the response time of anesthesia personnel from the time they are paged to arrival at the patient’s bedside to 30 minutes The laboring patient will have a decrease in her VAS score post epidural placement Confidential Quality Improvement Material

Forces of Magnetism Force 7: Quality Improvement Force 13: Interdisciplinary relationships: Collaboration with nurses & physicians to improve quality of care Confidential Quality Improvement Material

Solutions Implemented Measure the response time of anesthesia personnel from the time they are paged to arrival at the patient’s bedside VAS scores were documented pre & post epidural placement Confidential Quality Improvement Material

Solutions Implemented contd. Project start date: July 2005 Educate anesthesia & nursing staff regarding project Audit charts for response time (response time & VAS scores) July 2007: Charts were audited for documented delay reasons of longer than 5 minutes from the goal time Follow up meetings with anesthesia to bring awareness of time delays: Monthly Results reported to to key stake holders & to Perinatal Task Force: Quarterly Confidential Quality Improvement Material

Analysis Anesthesia response time has decreased from an average of 29 minutes in 2005 to 18 minutes in 2008 Patients reported VAS scores of 7/10 prior to epidural placement Patients reported VAS scores of 0/10 after epidural placement Individual feedback to anesthesia personnel was most beneficial Confidential Quality Improvement Material

Goal: 30 minutes Goal 25 minutes Goal 20 minutes Project start date?

Next Steps Discuss with Perinatal Quality Task Force & Anesthesia Leadership to further decrease goal wait time to 15 minutes Assess Hospital Consumer Assessment of Healthcare Providers & Systems (HCAHPS) scores to monitor patient satisfaction with labor pain management Confidential Quality Monitoring Monitoring