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  5. OB Team 12/24 hr Survey

OB Team 12/24 hr Survey

Sky OB Call Survey
 
 
Hello Everyone,

As you know SDA has obtained the Sky OB coverage contract for Kaiser for the next 5 years. Currently Kaiser deliveries are averaging 10/month but are slated to increase to 60 per month starting in October and could eventually reach 120 per month in 1-2 years time depending on Sky capacity. Sky Administration also hopes to increase the private delivery volume with a goal of 5000-6000 deliveries per year up from the current volume of 2500 per year. The SDA board and Sky leadership team feel we should be proactive with covering this increase in volume and possibly change our call structure in order to 1) more safely care for our patients and 2) prevent OB team member burnout.

At the two OB call coverage planning meetings many good ideas were discussed, but as the sample size attending was small no one felt comfortable proceeding without getting a survey of OB call team member’s opinions. Please consult the meeting materials sent out previously for more details. In the absence of a significant number of team members leaning in one direction or another, the BOD will be forced decide the best coverage structure. However, everyone involved would prefer that the OB team comes up with its own coverage plan.

Criteria for call structure changes will adhere to the following principles:
1) Revenue neutrality - meaning that if the OB delivery volume increases by 1 FTE's worth of value (or approximately 60 additional deliveries per month), then we have that FTE to work into our call structure.
2) Acceptable to the majority of OB call team members
 
 
 
1. Do you think we should move to 12 hour OB shifts or stay with 24 hour call shifts at Sky Ridge Hospital?
 
12 hour shifts
 
24 hour shifts
 
 
 
2. If you prefer to remain with 24 hour shifts, do you see a foreseeable delivery threshold where we should go to 12 hour shifts?
 
No
 
Yes, but only after deliveries are 30-60 higher per month than current volume. (A pre-call day off would be possible, but the SKOB stipend would be removed)
 
Yes, but only after deliveries are 60-120 higher per month than current volume. (A pre-call day off would then be possible keeping current stipends.)
 
Other
 
 
 
3. Do you prefer a 12 hour call shift with the pre-call day off? (as opposed to a pager day, etc.)
 
Yes
 
No
 
 
 
4. If there is a call to move to 12 hour OB shifts, the OB team must adhere to a financial structure that remains reasonably cost neutral to the 1st call team. What would be your preference to accommodate this initially?

Options while keeping the SKOB stipend include:
 
Continue doing 24hr shifts until the added volume covers a full pre-call paid day off.
 
Create a Sky OB pre-call pager doc (1-6 TBD) or other morning assignment system (see question 5 below)
 
Go to 12 hr shifts, but institute multiple evening shifts in a row (2-5) in order to cover with existing manpower until volume ramps up.
 
Other
 
 
 
5. If 12 hour shifts are instituted prior to volume being adequate for the pre-call day off, please choose an option for the pre-call day.
 
Create a temporary OB call priority pager position (1-6 TBD)
 
Have the night OB call doc scheduled to work a light morning in the OR
 
SKOB deck in the morning and relieved for a period of time before the night call shift starts.
 
 
 
6. If a pager system is instituted what pager priority should the pager position be
 
1
 
2
 
3
 
4
 
5
 
6
 
 
 
7. Would you be willing to give up your SKOB call stipend in order to achieve a pre-call day off at a lower deliver volume threshold?
 
Yes
 
No
 
 
 
8. Once the OB volume increases to > 100 deliveries over current volume we need to consider ways of handling the volume safely while reducing burnout. Your preference would be?
 
Making SKOBB a second a full time in-house position.
 
Have 1 in house person with 2 backups (an A/B) possibly requiring one in house based on volume on deck.
 
 
 
9. If in the future two docs are always in house is a third person on back-up still required?
 
Yes
 
No
 
 
 
10. Are you in favor of a split OB/1st call position?
 
Yes
 
No
 
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