Ask ECRI: Providing Obstetrical Services When Understaffed

​A member recently asked about considerations and potential risks related to merging an obstetrics (OB) unit with a medical-surgical unit and going "on diversion" for OB services when understaffed. In our response, we discuss concerns related to these changes, including standards of care, staffing levels, risk assessments, state and federal laws and regulations, and security.

​In recent years, more OB units in rural areas have experienced closures and maternity care deserts have grown. In response, many rural healthcare organizations are exploring creative approaches in their efforts to maintain OB and gynecology (OB/GYN) services for their patients. The National Rural Health Association describes some of the approaches hospitals and policy makers have taken to try...