In the fluorescent-lit corridors of UCHealth’s obstetric emergency department, the scene had become all too familiar: anxious mothers-to-be waiting for care, overwhelmed midwives juggling multiple cases, and a mounting sense that the system was reaching its breaking point. It was on one such day that Sara Price, CNM, WHNP-BC, MSN, had an epiphany that would reshape how the department delivers emergency obstetric care.
A Department Under Pressure
The numbers tell a stark story.
CU Nursing's Sara Price, CNM, WHNP-BC, MSN. |
When Price joined the Center for Midwifery at Anschutz Medical Campus in 2018, the department handled approximately 400 patients monthly. Today, that figure has surged to nearly 700 – double the facility's intended capacity of 350. The center, which treats pregnant and postpartum patients from 20 weeks gestation through six weeks after delivery, was buckling under the strain.
"We were getting to a point where we didn't have enough rooms for patients," says Price, who serves as the Interim Practice Lead for the University Nurse Midwives, is a senior instructor of clinical practice at CU Nursing where she recently completed her Doctor of Nursing Practice degree. "This wasn't sustainable – or acceptable – for our patients, nurses, and midwives."
From Chaos to Clarity
The solution, Price discovered, was hiding in plain sight. While reviewing protocols used by other obstetric emergency departments, she found that many facilities employed an acuity-based triage system – a method of prioritizing patients based on the severity of their condition rather than their arrival time. Remarkably, this system was already built into the center's electronic medical records but had never been implemented.
This problem became the basis for her DNP project (required to finish her degree) which focuses on applying research to clinical practice, leadership and health policy to improve patient care.
"My project focus was to shift our work culture," Price explains. "We needed to move away from the first-come, first-serve approach and start prioritizing patients based on their medical needs."
Transforming Care Through Technology
Over nine months, Price led a comprehensive training program. Nurses learned to assign scores to incoming patients based on factors such as their presenting symptoms and pain severity. Midwives were trained to prioritize cases based on these triage scores.
The results were surprising. Despite initial concerns about longer treatment times affecting patient satisfaction, the opposite occurred.
"As we got more efficient in seeing patients, our treatment times actually decreased," Price notes.
The new system also brought unexpected benefits to the workplace culture, with staff reporting greater confidence in their decision-making and ability to focus on critical cases.
A Model for the Future
The success of Price's initiative extends beyond improved efficiency. It demonstrates how frontline healthcare workers can drive systematic change in emergency care delivery. Hospital leadership has embraced the new protocol, raising hopes for additional resources to support the department's growing needs.
"This shows how strong midwifery and nursing are when we come together," Price reflects.
In an era of increasing pressure on maternal healthcare systems, her innovation offers a blueprint for other facilities facing similar challenges.
For the mothers who arrive at the Center for Midwifery's doors each day, Price's "eureka moment" has translated into something invaluable: the assurance that when emergency strikes, they'll receive care precisely when they need it most.
