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Test of change streamlines tubal ligations

22 Jan 2017

By: Matt Boles, MD, medical director of Surgical Services

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Early this fall, Lisa Rice, MD, brought together a group of individuals to help solve a dilemma for her patients and those of other obstetricians. She identified a problem where post-partum patients who desired sterilization were not able to have their tubal ligation done prior to their discharge. This caused a lot of consternation to both the patients and obstetricians and was a dis-satisfier to all the parties involved as these patients would have to return to the hospital on a later admission to get this done.

Barriers seemed to mainly lie in the fact that tubal ligations were traditionally done in Labor and Delivery. And because of the unpredictable nature of the child bearing business, emergency cesarean sections or frequent busy laboring days would take away resources that otherwise would be available to staff the tubal ligations.

In October, I worked with Irina Hyde, an assistant nurse manager from the OR, and Jen Henkel, manager from Labor and Delivery, to develop a test of change to increase the opportunities for tubal ligations to be performed prior to the patient’s discharge. This included performing these tubals in non-traditional areas, including the operating room. 

At our October baseline, we serviced three patients. Then in November, that number rose to seven.  And in December, we had 14 patients that had a tubal ligation with six of these being performed in the operating room. So in a short amount of time, we have more than quadrupled the number of tubals done at Salem Health.

Thank you to all that participated in this project and we hope to see this trend continue!