Increasing effective postpartum care in an obstetric clinic using ACOG's postpartum toolkit.

Abstract

Approximately 69% of maternal mortality occurs in the postpartum period. Contributing factors include the absence of preparation of pregnant women for the postpartum period during the antenatal period, postpartum follow-up care not being scheduled until 6weeks after childbirth, and the lack of further care coordination. The aim of this project was to increase the frequency of effective postpartum care visits to 80% in 8 weeks at an urban obstetric clinic. A quality improvement project was conducted through four Plan-Do-Study-Actcycles over 8weeks. Postpartum Readiness & Awareness Tools (PRATs) were reviewed with patients during their late third trimester, to review postpartum warning signs that warrant further evaluation. A population health registry was created to manage early follow-up for newly postpartum patients, to ensure their recovery was progressing normally. A note template was created and implemented to guide the completion of comprehensive postpartum visits. Over 8weeks, 188 patients received 1of the 3standardized interventions. Effective postpartum visits increased to 88%. The PRATs increased patient postpartum warning sign knowledge, with a project mean risk factor knowledge score of 6 (Goal = 5). The population health registry drove right care by ensuring early postpartum patients were recovering as expected, as seen by a project mean right-care score of 16 (Goal = 12). The note template increased the effectiveness of postpartum visits, with a mean effective postpartum care score of 10 (Goal = 10). The PRATs, population health registry, and note template collectively increased the quality and effectiveness of postpartum care.