Purpose: To describe the design
and implementation of a resident driven QI initiative which addresses the low
percentage of patients returning for a 6-week postpartum visit in a resident
obstetrics clinic.
Background: The
postpartum period or the “fourth trimester of pregnancy” is a critical period
for women’s health and well-being. At our resident clinic (2014-2016),
only 21% of patients presented to their 6-week postpartum visits compared to
80-93% in other practices. As part of a new, mentored experiential
approach to QI education, our residents completed a QI project based on an
identified clinically relevant patient care issue.
Methods: 12
Ob/Gyn residents (single institution) completed the IHI QI Online modules as
part of a GME supported Health Systems Science initiative focused on operationalizing
a Triple Aim targeted curriculum. Applying the Model for Improvement, the
residents designed and implemented a QI project with the aim of 100% of
postpartum patients discharged from the resident service during a 6-month
period to receive a 2-week post-discharge check-in call. The % of
discharged patients attending their 6-week postpartum visit was calculated and
compared to the % attendance 2014-16. Data analysis: independent t test,
P<0.05
Results: 6 months
after implementation, 97%(37/38) of patients received a 2-week check-in
call. Of those contacted, there was a 45% increase in patients who
returned for a 6-week postpartum visit (p<0.01).
Discussions: An educational
intervention can directly improve patient care. An experiential approach
to QI can facilitate knowledge application and result in improved postpartum
care utilization for high risk patients.
Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Residency Director, Residency Coordinator, Systems-Based Practice & Improvement, GME, CME, UME, Quality & Safety, Problem-Based Learning,
Jessica Parson,
MD, University
of Vermont Medical Center; Katherine
Menezes, MD;
Stephanie Mann,
MD
