The Obstetric Emergency Department: Need, Rationale, and Guide to Implementation

The last two decades have seen dramatic growth in the number of obstetrics and gynecology hospitalists (OB/GYN hospitalists), and many hospitals have created obstetric-specific emergency departments. The goals of an obstetrics emergency department (OB ED) are to provide safe and efficient care to the pregnant dyad and postpartum patient, while also generating revenue for emergency services provided. In an OB ED, all patients must be evaluated in person by a licensed practitioner, whereas historically they may have been evaluated in person by nursing staff or a trainee. We make the argument that formation of an OB ED has the potential to improve the safety and quality of patient care. In addition, the financial benefits to institutions are substantial and can subsidize the cost of maintaining 24/7 obstetrician presence in the hospital. There are various regulatory requirements to become certified, accredited and licensed as an emergency department. There are also many operational and systems issues that institutions should consider prior to implementation. We provide a guide for health care systems considering creating an OB ED.