Quality Improvement Project to Increase Postpartum Clinic Visits for Publicly Insured Women

Abstract

ObjectiveTo increase the percentage of women who attend postpartum visits and decrease the number of days to the first postpartum visit by implementing a scheduling change. DesignQuality improvement project. Setting/Local ProblemA small nurse practitioner maternity care clinic in an academic health center at which only 74% of the women who attended two or more prenatal visits attended postpartum clinic visits. ParticipantsA diverse sample of 25 publicly insured women who gave birth during the 5-month implementation period. Intervention/MeasurementsWe added a 2- to 3-week postpartum appointment to our standard 6-week postpartum appointment. The measurable outcomes were the percentage of women who attended postpartum clinic visits and the number of days to the first postpartum visit. ResultsDuring the first 4 months of the 5-month project implementation phase, 14 of the 20 (70%) women who gave birth attended postpartum visits. The attendance at postpartum visits in the last month of the project was 100% (all five women). Days to first postpartum visit decreased from a mean of 40.7 in the baseline year to a mean of 21.8 by the last month of project implementation. ConclusionDespite the small scope of this project, our outcomes support continuing the practice of scheduling an earlier postpartum clinic appointment. The timing for when to preschedule postpartum appointments and contextual factors, such as the availability and use of telehealth technology and COVID-19 pandemic challenges, should be considered when implementing similar projects in other settings.