Study of the functioning of the casualty department of obstetrics and gynecology in a tertiary care hospital

Delay of more than 4 hours in admitting patients from the time of arrival in emergency department has adverse outcomes. With no study available related to Obstetrics emergency department, our study aimed to assess the emergency obstetrics department's functioning in a tertiary care hospital, focusing on admission times, critically ill cases, referrals, and need for surgical intervention to improve patient outcomes. METHODS We did an observational study in a tertiary care hospital's obstetrics emergency department over 4 months (April-July 2024) and reviewed 1000 cases by hospital records. Data related to arrival time and admission, day/night variations, referral cases, critical care admissions, surgical interventions and mortalities was collected. The study correlated arrival to admission time with various factors RESULTS On analyzing 1000 cases, we found a mean admission time from casualty arrival of 2.7 hours (day- 2.7 hours, night- 2.5 hours, p<0.05), with 58.6% requiring admission, and 18.8% needing immediate surgery. Intensive monitoring was required in 75% of admitted patients with 1 mortality. The referred cases were 25.6% with maximum referrals from Delhi. Patient volume and admission frequency positively correlated (R=0.77 and R=0.38 respectively) with admission time. CONCLUSIONS The mean admission time from casualty to ward was within the 4-hour international standard. It wasn't significantly affected by patient referral status, or need for critical care/surgery. Increased workload correlated with longer admission times (R=0.77). Thus, establishing a benchmark for admission time in the emergency of obstetrics and gynecology department in a Government tertiary care hospital and identified potential areas of improvement.