Prenatal Care Process Improvement in Pregnant Patients with Opioid Use Disorder in an Outpatient Substance Use Disorder Treatment Clinic

Abstract

Opioid use disorder (OUD) in pregnancy is a public health concern that negatively impacts maternal and fetal health outcomes. Multiple barriers to OUD treatment exist and lead to delayed treatment. Early treatment access and collaborative care among providers can improve maternal and fetal health outcomes. The Doctor of Nursing Practice (DNP) project aimed to improve outcomes in pregnant individuals with OUD through early referrals and collaborative care. The project sought to establish and enhance a referral system in a novel collaborative care partnership between an outpatient substance use disorder (SUD) treatment clinic and an obstetric (OB) clinic in central North Carolina. The quality improvement project occurred over a 12-week implementation span during the spring of 2023. During that time, care coordination meetings occurred to establish a referral process, and multiple Plan-Do-Study-Act cycles occurred throughout implementation to improve the referral process. Seven referrals were received, and two patients enrolled in treatment and collaborative care at the SUD and OB clinics. Follow-up satisfaction ratings revealed that the OB clinic staff reported feeling very satisfied with the process and thought the partnership met patient needs. The DNP project represents a novel partnership in the high-needs geographic area that provides improved treatment access to pregnant women with OUD. The DNP project established a successful referral process and is part of a long-term collaborative care partnership to improve pregnancy outcomes.