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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.
Summary
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.
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.
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