Online Program

Adopting an integrated care model to transform pregnancy care within a major OB/GYN residency-based program

Monday, November 4, 2013 : 11:20 a.m. - 11:35 a.m.

Sadaf Rafique, MS, Department of Health Analytics-Research and Information Management, University Heath System, San Antonio, TX
Jana Sullivan, CNM, MSN, Department of OB/GYN, University of Texas Health Science at San Antonio, San Antonio, TX
Camerino I. Salazar, MS, Health Analytics, Research and Information Management, University Health System, San Antonio, TX
Ebony Weston, FACHE, Women's and Preventive Health Services, University Health System, San Antonio, TX
Matthew Lee Smith, PhD, MPH, CHES, Department of Health Promotion and Behavior, Workplace Health Group, University of Georgia, Athens, GA
In efforts to strengthen the pregnancy care delivery model within its Ob/Gyn Residency program, University Health System (UHS), the safety net health provider for South Central Texas, adopted and implemented CenteringPregnancy®. This multi-component care model was developed by the Centering Healthcare Institute™ (CHI) to provide individual health assessment, education, and supportive care to pregnant women with similar gestational ages in a group setting. Utilizing CHI's organizational self-assessment readiness tool, UHS established an interdisciplinary team to address all facets of the CenteringPregnancy® Model. A 12-month site review was performed that comprised observations of a Centering group session, document and data indicator review, as well as interviews with group participants, providers, staff, and other stakeholders. In September 2012, UHS became the first public hospital in the region to be recognized by CHI for meeting model-specific standards and its 13 essential elements of model fidelity. Compared to baseline, a review of indicators found that Centering participants (N=36) displayed better prenatal appointment attendance (90% at follow-up versus 78% at baseline) and lower pre-term (<37 weeks) delivery rates (7% versus 10%); however, the percentage low birth weight deliveries (<2500g) did not significantly improve (12% versus 10%). When compared to traditional care patients, Centering participants reported getting care more easily (96% versus 67%) and greater provider satisfaction (94% versus 89%). Incorporating a prenatal care delivery model can strengthen adherence to clinical care, build trust with providers, develop a peer support system, and improve patient experience, translating into improved birth outcomes for both mother and child.

Learning Areas:

Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Provision of health care to the public

Learning Objectives:
Describe the theory, design, and implementation of a health service intervention that targets economically underserved women who are pregnant. Evaluate reach and effectiveness of a program tailored towards promoting a positive patient experience and improves birth outcomes. Discuss lessons learned, challenges, and opportunities for sustainability of group visits in efforts to provide high quality, patient-centered care within a major safety-net hospital.

Keyword(s): Pregnancy Outcomes, Prenatal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the lead evaluator for multiple grant funded projects pertaining to women's preventative health services. In my current capacity I am responsible for the designing and coordination of community health improvement efforts within a major safety-net healthcare system.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.