Exploring Services Across Our Community:
Women & Children

Why This Program?

The current national shortage of OB/GYN physicians presents notable recruitment and retention challenges. Samaritan Health Services currently has five OB/GYN physician vacancies across its service area, some of which have remained unfilled for over 12 months. As a result, Samaritan has relied on temporary physicians and Labor & Delivery nurses to maintain necessary coverage, leading to prohibitively high expenses. 

To address these issues, Samaritan is evaluating opportunities to redesign the Women & Children program in order to:

  • Enhance patient access to outpatient services.
  • Expand the range of services provided.
  • Improve clinician recruitment efforts.
  • Reduce the burden of being on call for our clinicians.
  • Improve the quality of care.
  • Pool our limited resources.
  • Reduce our reliance on external temporary support in a model that is financially sustainable moving forward.

Proposed consolidation of Labor & Delivery services would allow for more efficient use of inpatient facilities, reducing the requirement to staff underutilized locations around the clock with specialized health care professionals. By concentrating Labor & Delivery services at three hospitals rather than five, we aim to mitigate the excessive on-call demands that negatively impact clinician recruitment and retention. These enhancements are expected to improve access to outpatient OB/GYN services, foster increased collaboration among clinicians and staff and strengthen the overall resilience of Samaritan’s Women & Children’s program. 

What’s Being Explored?

Samaritan clinicians, leaders and analysts and exploring all aspects of the Women & Children’s clinical program, including:

  • Maintaining all current outpatient OB/GYN and pediatric clinics.
  • Regionalizing OB/GYN groups in the Willamette Valley and on the Central Oregon coast.
  • Streamlining delivery services and pediatric support functions by consolidating these services from five hospitals to three.
  • Increasing outpatient gynecologic surgery at all hospitals.
  • Significantly reducing call burden and the need for temporary staffing .
  • Recruiting one additional OB/GYN physician for the coast.
  • Adding an outpatient Maternal & Fetal Medicine program focused on care during high-risk pregnancies, minimizing the need for patients to seek these services outside the community.

2024 Data & Demographics

Clinical Statistics

  • 43,000 clinic visits.
  • 1,750 surgical cases.
  • 1,849 deliveries across Samaritan’s five hospitals:
    • GSRMC: 972
    • SAGH: 405
    • SLCH: 226
    • SPCH: 127
    • SNLH: 119
  • 78% of deliveries in our service area occurred at Samaritan hospitals. 
  • Residents who receive care out of the area do so due to high-risk pregnancy/birth circumstances or personal preference.
  • Number of days with no deliveries in 2024:
    • SNLH: 260 days.
    • SPCH: 256 days.
    • SLCH: 193 days.
    • SAGH: 122 days.
    • GSRMC: 25 days.

In total, there were 856 hospital days where mandatory staffing was required despite no deliveries occurring, resulting in an estimated cost of $10 million—costs not reimbursed by payers. The direct loss on obstetric services totaled $7.8 million, accounting for all deliveries at Samaritan hospitals. 

Geographical Considerations

East Linn County: Two-thirds of residents delivered outside Lebanon; 24% delivered at GSRMC, and 20% at SAGH. The drive from Lebanon to Corvallis or Albany ranges from 14 to 21 miles, approximately 25 to 35 minutes. 

North Lincoln County: 77% (69 individuals) chose Samaritan North Lincoln Hospital for delivery. The distance from North Lincoln to Newport is 28 miles, with travel times ranging from 45 to 90 minutes depending on conditions. 

All Samaritan birth centers meet established standards for maternal morbidity/mortality and obstetric service quality. Consolidating deliveries to three hospitals is projected to maintain or enhance these outcomes through greater consistency, concentrated expertise, and decreased dependence on temporary staff. 

Importantly, this approach will not create maternity care deserts—U.S. counties lacking maternity resources—as outpatient and prenatal services will be maintained at all current locations. 

Staffing

  • Even when there are no patients, each birth center must meet a mandatory staffing obligation 24 hours a day, every day of the year and have active availability of numerous wrap-around service capabilities. 
  • To ensure coverage at all times, providers in four of five hospitals are routinely on call one of every two or three days. 
  • Call burden negatively impacts recruitment and retention. By creating regional groups, the call burden would be significantly reduced.
  • 20 OB/GYN providers currently employed.
  • Five open positions under recruitment.
  • By pooling resources at three locations, only one additional OB/GYN position would remain under recruitment.
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