Findings from the Healthy Start Interconception Care Learning Community

Issues: In 2005, the Health Resources and Services Administration (HRSA) Division of Healthy Start and Perinatal Services (DHSPS) required Healthy Start projects to provide interconception care due to its importance in improving maternal and infant outcomes. In 2008, HRSA/DHSPS invested in a large-scale, three-year quality improvement (QI) project, to both improve interconception care services and to incorporate QI techniques into management practices.

Description: The Institute of Healthcare Improvement (IHI) Learning Collaborative Model (usually implemented in clinical settings) was adapted for Healthy Start community-based service organizations. One of the most complex and innovative quality improvement collaboratives sponsored by the federal government, it included 100 Healthy Start teams organized into 15 Learning Collaboratives working on an improvement such as strengthening partnerships, using evidence-based tools, or improving staff skills, in the area of case management, family planning, healthy weight, maternal depression, primary care, or screening assessment.

Lessons Learned: A readiness survey found significant changes in Project Director perceptions over time, e.g. “The majority of my respected peers are dedicated to making this change work” (33% increase.) Preliminary data for 64 teams indicated that 32 held staff trainings for a total of 398 staff trained, 10 pursued community linkage activities leading to 49 established partnerships, and 22 incorporated evidence-based tools into services, of which 15 teams screened a total of 1,171 women. Qualitative data indicated that teams adopted systematic approaches to change and encouraged peer-to-peer learning and accountability. Recommendations: Quality improvement techniques can be more creatively and broadly utilized to improve public health services.