Tuesday, March 26, 2019 2:00 p.m. Eastern Dial In: 888.863.0985 - - PowerPoint PPT Presentation

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Tuesday, March 26, 2019 2:00 p.m. Eastern Dial In: 888.863.0985 - - PowerPoint PPT Presentation

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Tuesday, March 26, 2019 2:00 p.m. Eastern Dial In: 888.863.0985 Conference ID: 7685694 Slide 1 Speakers Melissa Heavican, MSN, RN, CPHQ, LSSGB Clinical Leader, Methodist Fremont Health Terese Moore, RN, IBCLC OB Nurse Navigator, Methodist

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Tuesday, March 26, 2019 2:00 p.m. Eastern

Dial In: 888.863.0985 Conference ID: 7685694

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Slide 2 Slide 2

Speakers

Melissa Heavican, MSN, RN, CPHQ, LSSGB

Clinical Leader, Methodist Fremont Health

Terese Moore, RN, IBCLC

OB Nurse Navigator, Methodist Fremont Health

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Disclosures

  • Melissa Heavican, MSN, RN, CPHQ,

LSSGB has no real or perceived conflicts of interest.

  • Terese Moore, RN, IBCLC has no real or

perceived conflicts of interest.

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Methodist Fremont Health

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Methodist Fremont Health

Update clinic info w H4W Methodist Fremont Healthcare for Women Office

  • 5 OB/GYN physicians
  • 1 OB Navigator
  • 9,286 visits
  • 3,544 patients

Methodist Fremont Health Hospital

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Objectives

  • Discuss the importance of establishing a comprehensive,

personalized postpartum care plan for every woman.

  • Review the essential components of a comprehensive

postpartum care plan including, access to breastfeeding support, educational tools, and community resources.

  • Provide an overview of strategies for successfully

conducting mental health and domestic violence screening.

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Previous State

  • Exclusive breastfeeding rates were not at our

goal

  • Prenatal education was attended 17% of the

time.

  • Care was segmented between outpatient and

inpatient

  • There was opportunity to increase domestic

violence screening

  • There was opportunity to increase Maternal

mental health screening, education, and support.

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Goals and Purpose

Purpose: Develop a standardize comprehensive maternal safety program Goals: Develop OB navigator role to address postpartum care basics for maternal safety, from before birth to the comprehensive postpartum visit through assessment tools and strong network.

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THE FOCUS

  • Exclusive breastfeeding rate CY 2015 57.73%
  • Increase mothers preference to breastfeed
  • Educate early
  • Give Support

Increase exclusive breastfeeding rate

  • Class attendance for CY 2017 17%
  • Offer online class in English/Spanish
  • Educate prenatal in office & encourage

enrollment

Increase attendance to childbirth education

  • Assessments were variable
  • Improved one assessment tool
  • Standardized approach to resource

Mental Health and Domestic Violence Screening

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Breastfeeding Assessment

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The Conversation

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Building the Support

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Fremont Breastfeeding Initiative

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Breastfeeding Trends

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Perinatal Education

  • InJoy education brochure moved from

hospital to clinic

  • Online classes offered in English &

Spanish

  • More 1:1 education

with navigator

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Attendance Increase

2017

  • Baby Basics 51%

– Enrolled 37 – Attended 19

  • Understanding Birth 50 %

– Enrolled 34 – Attended 17

  • Online Class

– Enrolled 14

2018

  • Baby Basics 66%

– Enrolled 38 – Attended 25

  • Understanding Birth

70 % – Enrolled 43 – Attended 30

  • Online Class

– Enrolled 42

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Safety at Home

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The Resource

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Mental Health Assessment

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Workflow

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Simplified Workflow

Patient registered for 1st visit Navigator schedules time with patient next visit After initial appropriate referrals, care plan, and follow up is established 28 weeks depression screens are repeated Patient delivers- SW/ Navigator to connect

  • n high complex cases

2 weeks after delivery

  • r 2-3 week for follow

up appointment repeat screen follow up

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Edinburgh Screen

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The Multidisciplinary Team

OB Physicians + OB Navigator + Medical Social Worker + Behavioral Health Therapy + OB Provider

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Fremont Family Coalition Community Response

  • Care Corps Family Services
  • Dodge County Head Start
  • Heartland Family Services
  • Low income Ministry
  • Lutheran Family Services
  • Pathfinder Support Services
  • Uniquely Your Stability Support
  • Three Rivers Health Department
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Referral to Behavioral Medicine

  • 2 referrals to BH
  • 11 referrals to BH
  • 15 mothers started antidepressants
  • 8 referrals to social work

2017 – Base Data

2018- Outcome Data

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Next Steps

  • Empower Training for 2019 for all LDRP nurses
  • Continue community outreach and awareness
  • Send additional RN to CLC training
  • Review skin to skin documentation/compliance

Increase exclusive breastfeeding rate

  • Continue to monitor education attendance
  • Follow up with mother about what information is

missing

Increase attendance to childbirth education

  • Continue to develop strong working relationships

with Home Health team to strengthen home visits.

  • Potential anxiety coping skills education/support

groups

Mental Health and Domestic Violence Screening

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References

  • Bridge. Retrieved from http://www.bridgefromviolence.com/home.html

Council on Patient Safety in Women’s Health Care (March, 2017). Postpartum Care Basics for Maternal Safety From Birth to the Comprehensive Postpartum Visit (+AIM). Retrieved from http://safehealthcareforeverywoman.org/patient-safety-bundles/postpartum-care-basics/ Fremont Breastfeeding Coalition (2015) Fremont Family Coalition (2015). Retrieved http://www.fremontfamilycoalition.org/

  • InJoy. Retrieved from (https://www.injoyonline.com/

The American College of Obstetricians and Gynecologists (February, 2016). Optimizing Support for Breastfeeding as Part of Obstetric Practice. Retrieved from https://www.acog.org/Clinical-Guidance-and- Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Optimizing-Support-for- Breastfeeding-as-Part-of-Obstetric-Practice

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Q&A Session

Press *1 to ask a question

You will enter the question queue Your line will be unmuted by the operator for your turn

A recording of this presentation w ill be m ade available on our w ebsite:

www.safehealthcareforeverywoman.org

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Click Here to Register

Next Safety Action Series

Ra cia l Disp a rities in Ma terna l Hea lth: Lev era ging the Postp a rtum Period to Find Solutions

Ap ril 12

2 p m Ea stern Tim e

  • S. Michelle Ogunwole, MD

General Internal Medicine Research Fellow Johns Hopkins Bloom berg School of Public Health

Kelly Bower, PhD,

MSN/ MPH, RN Assistant Professor Johns Hopkins School of Nursing

Andrea N. William s- Muham m ad, CBD, CPD, CCBE

Birth/ Reproductive Justice & Equity Advocate Baltim ore Com m unity Doulas