Redesigning induction of labour processes.

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Healthcare Operations Management

Background:

• Induction of labour (IOL) aims for safe, efficient, and satisfactory birth outcomes.
• Current IOL scheduling often results in delayed starts and after-hours births.
• Optimizing IOL commencement times is crucial for improving patient care and resource utilization.

Purpose of the Study:

• To evaluate the impact of an 11:00 hours commencement time for induction of labour (IOL).
• To assess changes in birth timing and associated obstetric outcomes.

Main Methods:

• A discrete-event simulation model informed the scheduling strategy.
• A retrospective cohort study compared outcomes before and after implementing a new IOL schedule.
• The primary outcome was the likelihood of an in-hours birth (07:00-19:00 hours).

Main Results:

• The new 11:00 hours IOL schedule increased in-hours births by 14.7% (68.4% vs 53.7%, P < 0.01).
• Overnight births were significantly reduced.
• IOL delays and admission-to-birth times decreased, with a greater likelihood of vaginal birth within 24 hours.

Conclusions:

• An 11:00 hours start time for induction of labour is associated with a significant increase in in-hours births.
• This scheduling adjustment improves efficiency and potentially enhances patient satisfaction.