Implementing effective care by improving attendance to the comprehensive postpartum visit in an urban hospital practice.

Abstract

Background: Approximately 40% of postpartum patients do not return for comprehensive postpartum visits. Up to 20% of postpartum patients suffer from depression or anxiety. One-third of deaths related to pregnancy occur between 7 days to 1-year postpartum. Only 27% of new moms returned for comprehensive postpartum or check-in visits during the first 3 weeks postpartum. The providers did not perform depression screening for these postpartum outpatients. This quality initiative aimed to provide effective care by increasing postpartum follow-up to 80% in 90 days.

Method: The core interventions in this project included schedule logs, telehealth check-in visits within 1-3 weeks postpartum, screening with the Edinburgh Postnatal Depression Scale (EPDS), and a team engagement plan.

Results: Sixty-eight percent (68.8%) of patients attended check-in visits, and staff screened 90.9% of patients with the EPDS. Patients who checked-in benefited from visits, making patients more than four times more likely to attend comprehensive visits. Overall attendance for the comprehensive visit increased from 27% to 57% (p < .001).

Discussion: This initiative increased attendance at postpartum visits at a statistically significant rate. Implementing a schedule log, postpartum check-in visits, and depression screening increased effective care and attendance at comprehensive postpartum visits.