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Redesigning the First Prenatal Visit: A Quality Improvement Initiative.

Diane Christopher1, Joellen Fresia, Jennifer Alexander

  • 1University of Colorado Anschutz Medical Campus, Aurora, CO.

Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality
|December 26, 2023
PubMed
Summary
This summary is machine-generated.

Redesigning the first prenatal visit significantly improved topic coverage and patient access by splitting it into two encounters. Maternal health outcomes were enhanced without impacting patient satisfaction.

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Area of Science:

  • Obstetrics and Gynecology
  • Quality Improvement Science
  • Maternal Health

Background:

  • Rising maternal mortality rates necessitate thorough first prenatal visits.
  • Current first prenatal visits often fail to address crucial topics.
  • A quality improvement initiative was needed to enhance prenatal care.

Purpose of the Study:

  • To redesign the first prenatal visit to improve topic coverage.
  • To integrate collection of social determinants of health data.
  • To enhance patient access and maintain patient satisfaction.

Main Methods:

  • A quality improvement project was implemented in an obstetrics and gynecology clinic.
  • The first prenatal visit was divided into two encounters: telemedicine and in-person.
  • Data were collected and compared before and after the intervention.

Main Results:

  • Median topic coverage increased from 70.0% to 95.6% (p < .001).
  • Social determinants of health were routinely collected (98.8%).
  • No-shows decreased (9.9% to 4.2%), improving patient access; patient satisfaction remained stable (p = .370).

Conclusions:

  • Separating the first prenatal visit into two distinct encounters improves topic coverage and patient access.
  • This redesigned model enhances essential aspects of prenatal care while maintaining patient satisfaction.
  • The intervention offers a scalable solution to improve maternal health during the critical initial prenatal period.