Home Visiting and Six Week Postpartum Visit

Abstract

Community Medicaid/self-pay obstetric clinics report that only 52% of their patients return for their 6-week postpartum visit. This process improvement project evaluated the improvement strategies of providing patient education, ensuring transportation, and providing an appointment reminder by a postnatal nurse home visiting program on return rates for the 6-week postpartum visit. After creation of an evidence-based educational pamphlet, the postnatal home visiting nurses and schedulers were educated on providing the educational pamphlet, setting up transportation if needed, and calling patients two days before their 6-week visit. First quarter 2017 pre-implementation data and first quarter 2018 post-implementation data about demographics and return rates were collected and outcomes compared. The population demographics of age, race, ethnicity, marital status, parity, payor group, and OB provider group for mothers visited were similar in both groups. In the pre-implementation group (n=172), 91 (52.9%) mothers returned for their 6-week postpartum visit. In the post-implementation group (n=131), 98 (74.8%) mothers returned for their 6-week postpartum visit, an increase of 21.9% (p < .001). Simple strategies such as providing education about the importance of the 6-week postpartum visit, ensuring transportation, and providing reminder phone calls by a nurse home visiting program increased adherence to the 6-week postpartum visit. Improving 6-week postpartum return rates can positively impact health prevention, wellness, and contraception use for the postpartum woman, potentially leading to prevention of unintended pregnancies.