Purpose: To use the principles of Teaming to assess social determinants of health (SDoH) factors and improve the education of vulnerable patient populations provided by an interdisciplinary team of providers.
Background: Not many studies have examined how potential SDoH factors can influence newborn readmissions. Early readmissions of healthy newborns may reflect an inadequate institutional assessment of maternal preparedness for discharge. A Teaming approach was chosen as the vehicle to identify those SDoH factors affecting an urban community hospital’s healthy newborn readmissions.
Methods: An interdisciplinary team of OBGYN residents, pediatricians, nurses, Quality improvement and Information Technologist specialists teamed collaboratively to actively consider where within the flow and processes of care SDoH factors could have influenced the readmission of a healthy newborn for bilirubin treatment and to determine where elements of care could be improved.
This study utilized retrospective chart review of both newborn and corresponding mother merged with a quality improvement (QI) design. Nine cases were deemed to be uncomplicated, term (37+ weeks gestation) newborns prior to discharge who were readmitted for phototherapy.
Results: Multiple maternal factors were identified as indicators necessitating improvements in inpatient case management and patient education. The factors included: no prenatal care, primiparous, no lactation consult, and history of previous newborn readmitted for phototherapy.
Discussions: The assessment of SDoH factors requires team based execution-as-learning to build learning into ongoing operations that challenge providers to continually evaluate existing protocols and procedures to improve the medical management of vulnerable and underserved OB patient populations.
Topics: CREOG & APGO Annual Meeting, 2021, Student, Resident, Faculty, Patient Care, Systems-Based Practice & Improvement, Practice-Based Learning & Improvement, GME, Problem-Based Learning, Team-Based Learning, Public Health,
Rosa Avila, MD, Adventist Health White Memorial; Tiffany Yang, MD; Cinna Wohlmuth, MD; Ernie Guzman, MD; Carlos Munoz; Natasha Ocean
