The development and management uses of a patient classification system for a high-risk perinatal center

A patient classification system for a labor and delivery unit, a maternal-fetal intensive care unit, and an antepartum monitored unit is a complex but necessary component for staffing units with frequently changing patient census and varying patient acuity. This article describes the processes used to develop such a classification system and to predict staffing needs, in advance, in four-hour time blocks in the labor and delivery unit and in eight-hour time frames in the maternal-fetal intensive care unit and the antepartum monitored unit. The article also identifies direct nursing care and indirect nursing care activities and defines the levels of care needed.