Conference Abstract Compendium Examples from the ... - CityMatCH

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2009 CityMatCH Urban MCH Leadership ConferencePrenatal care in transition: A collaborative direct care modelPRIMARY CONTACT:Rosemary Howlett, ARNP, BSN, RNCDivision Head, Maternal/Child HealthUnified Government Public HealthDepartment619 Ann AvenueKansas City, KS, 66101-3099Phone: (913) 573-6750Fax: (913) 573-6765Email: rhowlett@wycokck.orgCATEGORYPreconception health and health careFOCUSProgram Policy FocusCO-PRESENTER(S)/AUTHOR(S):Terrie Garrison, tgarrison@wycokck.org(Presenter)ISSUEThe principal goal of a collaborative direct care model is to help ensure early, comprehensive and qualityaccess to prenatal care for the uninsured and underinsured pregnant women in Wyandotte County,Kansas.SETTINGWyandotte County is the smallest geographic county in Kansas, but one of the most densely populated. Itstruggles with higher rates of unemployment, uninsured, poverty, and teenage pregnancy than the stateaverage.The Wyandotte County Prenatal Care and Referral Program, administered through the UnifiedGovernment Public Health Department’s (UGPHD) Prenatal Program in Kansas City, Kansas/WyandotteCounty partners with two birthing hospitals (one of these is a medical center of a state university), privateOB/GYNS, state laboratory, and a private imaging service.PROJECT MODELIn December, 2006, the UGPHD transitioned from a decades-old, on-site, comprehensive prenatal careservice delivery model. Focusing on the public health needs of the community and the health care needsof non-insured pregnant women, the UGPHD launched a prenatal care and referral program, working withcommunity physicians and hospital providers to care for these women during their pregnancies. TheUGPHD coordinates each woman’s prenatal care needs; conducts education classes critical to ensuringhealthy pregnancies; provides histories, screenings, routine initial lab and pharmaceuticals; and linkswomen to participating medical and radiology providers for their prenatal care visits.ACCOMPLISHMENTS/RESULTSIn 2007, 266 women received prenatal care through the new program. All women were uninsured. Thevast majority were white, Hispanic and lived at or below 133% of the federal poverty level.134
2009 CityMatCH Urban MCH Leadership ConferenceProgram Successes:• Clients generally complied with program requirements and provider expectations.• Pregnancy and prenatal education received commendations from participating providers.• The referral/case management process differs slightly by provider and client needs and was noted as astrength of the program.EVALUATION PLANEvaluation of the program began in November, 2007, with a published report in May, 2008. Theevaluation involved conducting interviews and site visits with providers, hospitals, and UGPHD staff todetermine how the program was functioning and to identify opportunities for improvement.BARRIERS• Lack of adequate public transportation for clients assigned to providers at a distance from their homes.• Interpretation (verbal) and translation (written) provider costs to meet needs of limited Englishproficiency clientele.• Lack of public health insurance to cover prenatal care costs for the pregnant non-citizen.LESSONS LEARNED• A more aggressive marketing campaign was needed to avert misinformation about the changing servicedelivery model.• Collaborative effort across governmental agencies, hospitals, private physicians and clients can beorganized around a public health need.• There is an important role for health department leadership to play regarding active participation incollaborative facilitation, coordination of the intervention model, and outcome evaluation.135
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