Tuesday, March 26, 2019 2:00 p.m. Eastern Dial In: 888.863.0985 Conference ID: 7685694 Slide 1
Speakers Melissa Heavican, MSN, RN, CPHQ, LSSGB Clinical Leader, Methodist Fremont Health Terese Moore, RN, IBCLC OB Nurse Navigator, Methodist Fremont Health Slide 2 Slide 2
Disclosures Melissa Heavican, MSN, RN, CPHQ, LSSGB has no real or perceived conflicts of interest. Terese Moore, RN, IBCLC has no real or perceived conflicts of interest. Slide 3
Methodist Fremont Health Slide 4
Methodist Fremont Health Methodist Fremont Health Hospital Update clinic info w H4W Methodist Fremont Healthcare for Women Office -5 OB/GYN physicians -1 OB Navigator -9,286 visits -3,544 patients Slide 5
Objectives • Discuss the importance of establishing a comprehensive, personalized postpartum care plan for every woman. • Review the essential components of a comprehensive postpartum care plan including, access to breastfeeding support, educational tools, and community resources. • Provide an overview of strategies for successfully conducting mental health and domestic violence screening. Slide 6
Previous State o Exclusive breastfeeding rates were not at our goal o Prenatal education was attended 17% of the time. o Care was segmented between outpatient and inpatient o There was opportunity to increase domestic violence screening o There was opportunity to increase Maternal mental health screening, education, and support. Slide 7
Goals and Purpose Purpose: Develop a standardize comprehensive maternal safety program Goals: Develop OB navigator role to address postpartum care basics for maternal safety, from before birth to the comprehensive postpartum visit through assessment tools and strong network. Slide 8
THE FOCUS • Exclusive breastfeeding rate CY 2015 57.73% Increase exclusive • Increase mothers preference to breastfeed • Educate early breastfeeding rate • Give Support • Class attendance for CY 2017 17% Increase attendance • Offer online class in English/Spanish to childbirth • Educate prenatal in office & encourage enrollment education Mental Health and • Assessments were variable • Improved one assessment tool Domestic Violence • Standardized approach to resource Screening Slide 9
Breastfeeding Assessment Slide 10
The Conversation Slide 11
Building the Support Slide 12
Fremont Breastfeeding Initiative Slide 13
Breastfeeding Trends Slide 14
Perinatal Education • InJoy education brochure moved from hospital to clinic • Online classes offered in English & Spanish • More 1:1 education with navigator Slide 15
Attendance Increase 2018 2017 • Baby Basics 66% • Baby Basics 51% – Enrolled 38 – Enrolled 37 – Attended 25 – Attended 19 • • Understanding Birth 50 % Understanding Birth 70 % – Enrolled 34 – Enrolled 43 – Attended 17 – Attended 30 • Online Class • Online Class – Enrolled 14 – Enrolled 42 Slide 16
Safety at Home Slide 17
The Resource Slide 18
Mental Health Assessment Slide 19
Workflow Slide 20
Simplified Workflow Navigator schedules After initial appropriate Patient registered for time with patient next referrals, care plan, and 1 st visit visit follow up is established 2 weeks after delivery Patient delivers- SW/ or 2-3 week for follow 28 weeks depression Navigator to connect up appointment repeat screens are repeated on high complex cases screen follow up Slide 21
Edinburgh Screen Slide 22
The Multidisciplinary Team OB Physicians + OB Navigator + Medical Social Worker + Behavioral Health Therapy + OB Provider Slide 23
Fremont Family Coalition Community Response • Care Corps Family Services • Dodge County Head Start • Heartland Family Services • Low income Ministry • Lutheran Family Services • Pathfinder Support Services • Uniquely Your Stability Support • Three Rivers Health Department Slide 24
Referral to Behavioral Medicine 2017 – Base Data 2018- Outcome Data -11 referrals to BH -2 referrals to BH -15 mothers started antidepressants -8 referrals to social work Slide 25
Next Steps • Empower Training for 2019 for all LDRP nurses Increase exclusive • Continue community outreach and awareness • Send additional RN to CLC training breastfeeding rate • Review skin to skin documentation/compliance • Continue to monitor education attendance Increase attendance • Follow up with mother about what information is to childbirth missing education Mental Health and • Continue to develop strong working relationships with Home Health team to strengthen home visits. Domestic Violence • Potential anxiety coping skills education/support groups Screening Slide 26
References Bridge. Retrieved from http://www.bridgefromviolence.com/home.html Council on Patient Safety in Women’s Health Care (March, 2017). Postpartum Care Basics for Maternal Safety From Birth to the Comprehensive Postpartum Visit (+AIM). Retrieved from http://safehealthcareforeverywoman.org/patient-safety-bundles/postpartum-care-basics/ Fremont Breastfeeding Coalition (2015) Fremont Family Coalition (2015). Retrieved http://www.fremontfamilycoalition.org/ InJoy. Retrieved from (https://www.injoyonline.com/ The American College of Obstetricians and Gynecologists (February, 2016). Optimizing Support for Breastfeeding as Part of Obstetric Practice. Retrieved from https://www.acog.org/Clinical-Guidance-and- Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Optimizing-Support-for- Breastfeeding-as-Part-of-Obstetric-Practice Slide 27
Q&A Session Press *1 to ask a question You will enter the question queue Your line will be unmuted by the operator for your turn A recording of this presentation w ill be m ade available on our w ebsite: www.safehealthcareforeverywoman.org Slide 28
Next Safety Action Series Ra cia l Disp a rities in Ma terna l Hea lth: Lev era ging the Postp a rtum Period to Find Solutions Ap ril 12 2 p m Ea stern Tim e Kelly Bower, PhD, Andrea N. William s- S. Michelle Ogunwole, MD MSN/ MPH, RN Muham m ad, CBD, CPD, CCBE General Internal Medicine Assistant Professor Research Fellow Birth/ Reproductive Justice & Equity Advocate Johns Hopkins School of Johns Hopkins Bloom berg Nursing School of Public Health Baltim ore Com m unity Doulas Click Here to Register Slide 29
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