Prenatal Care Webinar. Luz Jimenez, RN, BSN VP Clinical Operations Erie Family Health Center

Transcription

1 Prenatal Care Webinar Luz Jimenez, RN, BSN VP Clinical Operations Erie Family Health Center

2 National Center for Health in Public Housing The National Center for Health in Public Housing (NCHPH), a project of North American Management, is supported in part by grant number U30CS09734 from the Health Resources and Services Administration. NCHPH provides training and technical assistance to strengthen the capacity of federallyfunded health centers to increase access to health care, eliminate health disparities, and enhance health care delivery for the millions of residents of public and assisted housing. The mission of the National Center for Health in Public Housing (NCHPH) is to strengthen the capacity of federally funded Public Housing Primary Care (PHPC) health centers and other health center grantees by providing training and a range of technical assistance.

3 Facts 34,627 Number of PHPC Obstetrician/Gynecologist s visits. 536 Number of visits to PHPC for perinatal conditions in 2010

4 Data

5 Data

6 Facts Barriers to accessing prenatal care for pubic housing women include: Transportation Lack of health insurance Lack of money Unable to get appointment when desired Unable to take time off work or school Lack of childcare for other children

7 Resources Prenatal care and tests What is prenatal care and why is it important? Barriers to Prenatal Care Barriers to Utilization of Prenatal Care for Low Income Women Living in Rhode Island: Impact of the Client-Service Provider Relationship

8 Facilitating Early Entry into Prenatal Care with Women s Health Promoters LUZ JIMENEZ, R N, BSN S E N I O R V I C E P R E S I D E N T C L I N I C A L O P E R A T I O N S E R I E FA M I LY H E A LT H C E N T E R

9 Objectives Discuss the role of Women s Health Promoter s in achieving early entry into prenatal care Discuss integration of Women s Health Promoters and early prenatal education in the primary care setting Discuss management and tracking of prenatal patients throughout pregnancy

10 Erie Family Health Center Located in Chicago Currently 12 sites, 14 as of July School-Based Health Centers 1 Freestanding Adolescent Health Center 6 Primary Care Centers - 3 dental centers 52,168 Unduplicated Users >153,000 Visits Annually 81% Hispanic; 55% best served in Spanish

11 Erie Family Health Center Payor mix: Uninsured 26% Medicaid 67% Medicare 3% Commercial 4% Deliveries: 1700 Quality: Early entry into prenatal care - 87% Low Birth weight rate - 5.4% Breast Feeding at 6mos - 30%

12 Background In 2000 Erie began to expand prenatal services, adding contracted OB/Gyne physicians from partner hospital to existing midwifery practice Fail rate among new prenatal patients was 30% Coordination of Care was limited Entry into prenatal care 77% in 2004 Demand for prenatal services was high among uninsured and underinsured population Need for culturally and linguistically competent care

13 Background Women s Health Promoters were introduced in 2005 as a way to: Assist pregnant women to establish early prenatal care by facilitating access and providing focused support Improve no show rate among new prenatal patients Provide early identification of high risk patients Provide early referral to supportive health and social services Provide early prenatal education Centrally manage patient panels by provider Gather and record delivery data

14 Who are Woman s Health Promoters? Anyone with an interest in woman s health, ability to communicate in the patient s preferred language, ability to conduct basic health assessments with training, collaborative, compassionate and nonjudgmental Doulas Health Educators Nurses Medical Assistants AmeriCorp

15 Integration of Women s Health Promoters into the Care Team First point of contact Member of the woman s health care team Attend team meetings Manage prenatal panels for delivering providers Follow up on transitions of care Consult with providers as needed

16 Role and Responsibilities Verification of Pregnancy o Advertised and offered free of charge o Performed by woman s health promoter (WHP) or lab staff who then refer to WHP o Women with negative result also referred

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18 Assessment Role and Responsibilities Feelings about the pregnancy Social and Family History Menstrual and Reproductive History Physical: height weight, blood pressure, EDD, current health conditions and medications Smoking Status Depression Screening (PHQ-2) Document in the electronic medical record (EMR)

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20 Education Role and Responsibilities What to expect during pregnancy Warning signs of miscarriage Breastfeeding Oral health Prenatal vitamins Nutrition Centering Pregnancy group visits Options counseling

21 Role and Responsibilities Administrative Assign patient to provider based on risk factors CNM vs. OB/Gyne or Delivering FP Track and Manage provider caseload Provide referral for dental care Provide prenatal packet to patient Provide referral for WIC Referral to Case Management Referral to Patient Benefits Advocate for assistance with enrollment in Medicaid

22 Entry into Care Verification of pregnancy Patient walks-in Lab staff perform test WHP notified or patient scheduled with WHP WHP notifies patient of result Assessment and documentation in EMR Determine appropriate provider Access EDD tracking tool for provider capacity Appointment Education Vitamins Referrals Completes ROI as needed Escorts patient to Case manager CM escorts patient to Patient Benefits Advocate (PBA) for MPE PBA staff escorts to WIC

23 Entry into Care New OB Appointment Patient receives appointment reminder 48 and 24 hours in advance Patient arrives for appointment MA intake using pre-visit guidelines for gestational age Provider Exam Ultrasound Labs Case manager Front desk schedules next appointment.

24 Entry into Care Failed Appointments PBA sets status of appointment as failed PBA generates No Show document in electronic medical record and routes to provider provider enters follow up instructions and routes to CM CM contacts patient and reschedules appointment

25 Entry into Care Delivery and Post Partum Care Patient care summaries generated from EMR and sent to delivering hospital at 34 weeks EMR also accessible by provider from L&D Newborn appointment made before discharge Delivery data received from hospital and tracked CM follows mom and baby for 12 months

26 EDD Tracking Providers empaneled based on specialty and clinical FTE Patients assigned based on high or low risk status and patient preference where appropriate WHP updates tracking tool to account for loss of pregnancy and transitions of care

27 EDD Tracking

28 Summary Women s Health Promoters can enhance early entry into prenatal care by serving as the initial point of contact for pregnant women in Community Health Centers Facilitate access and referrals to other critical social and health care resources Provide vital education and support Assist in managing provider empanelment and monitoring of outcomes

29 Thank You!

30 Q&A If you would like to ask the presenter a question please submit it through the questions box on your control panel If you are dialed in through your telephone and would like to verbally ask the presenter a question, use the raise hand icon on your control panel and your line will be unmuted.

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