Planning, Implementation, and Evaluation of a Postpartum Nurse Home Visit Service to Improve Health Equity

Objective

To describe how a college of nursing and urban academic medical center partnered with the local health department to plan, implement, and evaluate a universal nurse home visit service to improve health equity in the postpartum period.

Design

Evidence-based practice.

Setting/Local Problem

Wide health disparity in rates of maternal and infant morbidity and mortality in Chicago, Illinois.

Patients

All patients who gave birth at the medical center and lived in Chicago.

Intervention/Measurements

A nurse home visit was offered after birth to all eligible patients beginning in March 2020. We used data from a Web-based platform to determine key performance indicators for the program and examined patient demographics to determine equitable delivery of the service for all visits provided in 2022.

Results

There were 1,488 patients eligible for a home visit and 714 who received a home visit. The average contact rate was 76%, the scheduling rate was 63%, the completion rate for scheduled visits was 76%, and the population reach was 48%. Sixty-eight percent of families visited were from high-economic-hardship zip code areas of the city. Eighty-one percent of visits resulted in at least one referral to meet a family’s need, and 98% of patients surveyed rated their visit as “very helpful.”

Conclusion

The successful implementation of this public–private partnership was due in part to an organizational culture that supports health equity initiatives, the inclusion of system-wide stakeholders, having a process in place to monitor outcomes, and hiring a diverse team of nurses who prioritize respectful patient-centered care.