Job Description
Position Summary
The Director of Labor & Delivery is the clinical and operational leader for the L&D unit, OB-ED/Triage, and peripartum areas (ORs/PACU/Antepartum as applicable). This role ensures safe, equitable, patient-centered, and financially sustainable care by aligning bedside practice with evidence-based protocols, regulatory standards, and institutional priorities. The Director partners tightly with Nursing Leadership, Anesthesia, Neonatology, and Maternal-Fetal Medicine to deliver excellent outcomes, experience, and access across the perinatal continuum.
Key Responsibilities
Clinical Quality & Safety
- Own the L&D quality agenda (maternal morbidity/mortality reviews, perinatal safety program, and event response).
- Lead adoption and reliability of national bundles (e.g., obstetric hemorrhage, severe hypertension, sepsis, VTE, oxytocin safety).
- Chair/Co-chair L&D Quality & Safety Committee; run monthly case reviews and Just Culture debriefs.
- Standardize induction/augmentation, VBAC, operative vaginal delivery, and cesarean decision pathways; ensure timely MFM escalation.
- Ensure 24/7 readiness for OB emergencies (massive transfusion, perimortem C-section, shoulder dystocia, eclampsia, obstetric anesthesia complications).
Operations & Throughput
- Oversee patient flow across OB-ED/Triage, L&D, ORs, and PACU; reduce bottlenecks and diversion.
- Set and monitor staffing plans with Nursing Leadership (ratios, acuity tools, charge structure, OB techs/MTAs, doulas).
- Optimize scheduling for OB hospitalists, midwives, attendings, and residents/fellows; maintain fair workload distribution and backup coverage.
- Ensure equipment readiness and capital planning (monitors, fetal surveillance, ultrasound, hemorrhage carts, OR equipment).
- Partner with Bed Management and NICU for timely maternal–newborn dyad placement.
Culture, Teaming & Education
- Foster a high-reliability, interdisciplinary culture (daily huddles, safety checks, structured handoffs, debriefs).
- Co-lead simulation program (hemorrhage, shoulder dystocia, neonatal resuscitation, OB code, OR crises) with Nursing/Anesthesia/NICU.
- Support resident, fellow, midwife, and nursing education; ensure competency validation and privileging standards.
- Promote respectful, trauma-informed, and culturally sensitive care, including language access and shared decision-making.
Patient Experience & Equity
- Improve HCAHPS/CG-CAHPS touchpoints (communication, pain management, newborn care education, discharge readiness).
- Track and close disparity gaps in outcomes and experience by race/ethnicity, language, and social risk factors.
- Integrate doulas, lactation, social work, behavioral health, and maternal wellness resources into routine care.
Compliance & Risk
- Ensure compliance with Joint Commission, CMS Conditions of Participation, state perinatal regulations, EMTALA (OB-ED), and payer requirements.
- Maintain/uphold credentialing, privileging, documentation, EMTALA logs, and OPPE/FPPE processes.
- Partner with Risk Management on event analysis, disclosure, and enterprise risk mitigation.
Data, Informatics & Continuous Improvement
- Define, monitor, and act on a robust KPI dashboard; lead Plan-Do-Study-Act (PDSA) cycles.
- Oversee EHR optimization (order sets, decision support, oxytocin titration tools, hemorrhage calculators, VBAC counseling & consent).
- Leverage remote/wireless fetal monitoring and telemetry to improve mobility and experience when available.
Strategy & Growth
- Align L&D capacity with service line strategy (acuity mix, induction scheduling, VBAC access, regional referral pathways).
- Support new program development (OB-ED/triage redesign, obstetric anesthesiology protocols, maternal fetal transport, high-risk clinics).
- Participate in budget planning; steward labor, supply, and implant costs; support contracting and value-based care initiatives.
Success Metrics (tracked monthly/quarterly)
- Safety/Quality: Severe Maternal Morbidity (overall & hemorrhage-related), transfusion rates, timely treatment of severe hypertension, postpartum readmissions, SSIs, EBL/QBL documentation reliability.
- Clinical Practice: NTSV cesarean rate, VBAC attempt & success, operative vaginal delivery utilization, induction length of stay, oxytocin guideline adherence.
- Operations: L&D and OB-ED door-to-decision times, OR start on-time rate, boarding hours, diversion episodes.
- Experience & Equity: HCAHPS domains, doula utilization, disparities dashboards with gap-closure projects.
- People & Culture: Staff engagement/retention, completion of simulations/competencies, event debrief closure rates.
- Finance: Cost per delivery, length of stay benchmarks, supply variance, value-based incentives achieved.
Qualifications
- Required: MD/DO in Obstetrics & Gynecology; board certified (or eligible with timeline). Active/unrestricted state license and hospital privileges; eligibility for malpractice coverage.
- Experience: 10-12+ years post-residency with demonstrated L&D leadership (e.g., OB hospitalist lead, unit medical director, chief resident/fellow, MFM). Experience with QI methodologies (Lean/Six Sigma) and perinatal safety bundles.
- Preferred: Fellowship training (MFM, MIGS, or other), Master’s degree (MPH/MHA/MBA), formal patient safety/quality certification (e.g., CPHQ, IHI). Experience in academic teaching and interdisciplinary simulation.
- Skills: Collaborative leadership with nursing/ancillary teams; data-driven decision-making; excellent communication; ability to lead through influence and manage change. Proficiency with EHRs (EPIC/Cerner), perinatal analytics, and credentialing/privileging processes.
Work Conditions
- On-site leadership presence with rotational evenings/nights/weekends as needed for visibility, mentorship, and incident support.
- Participation in clinical call (as defined with the Chair) to maintain bedside credibility and understand workflow realities.
- Physical demands consistent with hospital environment and OR/L&D settings.
Professional Expectations
- Model Just Culture and psychological safety; promote respect and zero tolerance for harassment or bias.
- Maintain CME/board certification and institutional education requirements (BLS/ACLS/NALS/NRP as applicable).
- Uphold HIPAA, EMTALA, and institutional compliance policies.