Increasing effective postpartum care in an obstetric clinic using ACOG's postpartum toolkit

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Quality Improvement Science

Background:

• Maternal mortality is disproportionately high in the postpartum period, with significant contributing factors including inadequate antenatal preparation and delayed postpartum follow-up.
• Current postpartum care models often lack timely follow-up and care coordination, exacerbating risks during this critical period.

Purpose of the Study:

• To enhance the frequency of effective postpartum care visits to 80% within an 8-week timeframe at an urban obstetric clinic.
• To implement a structured quality improvement initiative to address deficiencies in postpartum care.

Main Methods:

• A 4-cycle Plan-Do-Study-Act (PDSA) quality improvement project was executed over 8 weeks.
• Key interventions included reviewing Postpartum Readiness & Awareness Tools (PRATs) with patients, establishing a population health registry for early follow-up, and implementing a standardized note template for comprehensive visits.

Main Results:

• The project successfully increased effective postpartum visits to 88%, exceeding the 80% goal.
• Patient knowledge of postpartum warning signs improved, with a mean risk factor knowledge score of 6 (goal=5).
• The population health registry and note template contributed to improved care coordination and visit effectiveness, evidenced by high 'right care' and effective postpartum care scores.

Conclusions:

• The integrated approach utilizing PRATs, a population health registry, and a standardized note template significantly improved the quality and effectiveness of postpartum care.
• These interventions collectively addressed critical gaps, leading to better patient outcomes and reduced maternal health risks.