Improved Value of Individual Prenatal Care for the Interdisciplinary Team.

Ella Damiano,Regan Theiler

doi:10.1155/2018/3515302

Abstract

Objective Innovative models of prenatal care are needed to improve pregnancy outcomes and lower the cost of care. We sought to increase the value of traditional prenatal care by using a new model (PodCare) featuring a standardized visit schedule and coordination of care within small interdisciplinary teams in an academic setting. Methods Prenatal providers and clinic staff were divided into four “Pods”. Testing and counseling topics were assigned to visits based on gestational age. Interdisciplinary weekly Pod meetings provided coordination of care. A retrospective chart review was performed. The primary endpoints were the number of prenatal care visits and number of providers seen. Results After PodCare implementation, more patients choose care with the low-risk physician team (42% compared to 26%). Study subjects included 85 women in 2013 and 165 women in 2014. The median number of visits decreased from 13 to 10 (p < 0.00004) and the median number of providers seen decreased from 7 to 5 (p < 0.0000008). Conclusion PodCare increased the value of individual prenatal care by decreasing the number of visits, increasing continuity, and providing care coordination. The model provides a robust experience in interdisciplinary care. The PodCare model may be successful at other academic institutions.

Highlights

Prenatal care seeks to mitigate risks and promote positive maternal and neonatal outcomes [1]
The American College of Obstetricians and Gynecologists (ACOG) recommends prenatal visits every four weeks until 28 weeks; every two weeks until 36 weeks and weekly until delivery [2]. This schedule is not data driven and increased frequency of prenatal visits does not correlate with improved outcomes [3]
Patient enrollment in physician or midwife care is a voluntary decision; care is provided by the maternal-fetal medicine (MFM) team when indicated by the patient’s condition

Summary

Introduction

Prenatal care seeks to mitigate risks and promote positive maternal and neonatal outcomes [1]. The American College of Obstetricians and Gynecologists (ACOG) recommends prenatal visits every four weeks until 28 weeks; every two weeks until 36 weeks and weekly until delivery [2]. This schedule is not data driven and increased frequency of prenatal visits does not correlate with improved outcomes [3]. National objectives and quality measures, such as Healthy People 2020 and the Healthcare Effectiveness Data and Information Set (HEDIS), feature similar goals for quality prenatal care These goals include improved timeliness of care and adequate attendance to visits and postpartum care [4, 5]

Methods

Results

Conclusion