Best practice: clinical pathways for uncomplicated births.

Background: A level II hospital with births exceeding 2000 annually was challenged by managed care companies to develop high-quality, cost-effective, and clinically efficient obstetric and newborn care under the constraints of a reduced length of stay.

Methods: As a result of the challenge, clinical pathways were initiated for vaginal and cesarean section births and for normal newborns.

Results: Successful implementation of the clinical pathways has decreased the average length of stay for uncomplicated deliveries from 2.02 to 1.67 days and for normal newborns from 1.99 to 1.43 days.

Conclusions: Data from quality outcome indicators that measure the rate of occurrence of emergency department admissions or hospital readmissions for either mother or newborn within 14 days of birth reveal no increase in either variance since the clinical pathways were implemented.