The medical database as a tool for improving maternal/infant continuity of care.
Analysis of the Sinai Health System's integrated medical database revealed a serious discontinuity of care, frequently observed in underserved communities, for mothers who delivered at the hospital but failed to return on a timely basis for postpartum visits for themselves and newborn visits for their babies. Since the Sinai Health System (SHS) is a fully integrated health system including community-based primary care, a process improvement project to improve rates of return was initiated. Prior to hospital discharge, a staff member visited each new mother and baby to schedule clinic follow-up appointments. Appointment compliance was monitored using the SHS integrated medical database. Results after the first year showed marked improvement. Eighty percent of mothers returned for postpartum care within 4 months of delivery compared to 46 at baseline. Eighty eight percent of newborns were seen in the clinics within the four month timeframe compared to a baseline of 59%. The integrated medical database not only allowed for identification of this problem but was an essential tool at each point in the intervention.
Miller
L P
LP
Mt. Sinai Hospital, Chicago, Illinois 60608-1797, USA.
Greenspan
B
B
Dowd
J S
JS
D001071:Appointments and Schedules; D002662:Child Health Services / Q000458:organization & administration*; D003266:Continuity of Patient Care; D019992:Databases as Topic; D019033:Delivery of Health Care, Integrated; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D007087:Illinois; D007223:Infant; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000458:organization & administration*; D008507:Medically Underserved Area; D010349:Patient Compliance; D010351:Patient Discharge; D049590:Postpartum Period; D011320:Primary Health Care; D017064:Process Assessment, Health Care; D017010:Reminder Systems