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Published on: January 12, 2018
Implementing effective care by improving attendance to the comprehensive postpartum visit in an urban hospital
Paige Rowland1, Christopher Kennedy2
1Department of Obstetrics and Gynecology, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Background:
Approximately 40% of postpartum patients do not return for comprehensive postpartum visits. Up to 20% of postpartum patients suffer from depression or anxiety. One-third of deaths related to pregnancy occur between 7 days to 1-year postpartum. Only 27% of new moms returned for comprehensive postpartum or check-in visits during the first 3 weeks postpartum. The providers did not perform depression screening for these postpartum outpatients. This quality initiative aimed to provide effective care by increasing postpartum follow-up to 80% in 90 days.
Method:
The core interventions in this project included schedule logs, telehealth check-in visits within 1-3 weeks postpartum, screening with the Edinburgh Postnatal Depression Scale (EPDS), and a team engagement plan.
Results:
Sixty-eight percent (68.8%) of patients attended check-in visits, and staff screened 90.9% of patients with the EPDS. Patients who checked-in benefited from visits, making patients more than four times more likely to attend comprehensive visits. Overall attendance for the comprehensive visit increased from 27% to 57% (p < .001).
Discussion:
This initiative increased attendance at postpartum visits at a statistically significant rate. Implementing a schedule log, postpartum check-in visits, and depression screening increased effective care and attendance at comprehensive postpartum visits.
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