title: Postpartum follow-up rates before and after the postpartum follow-up initiative at Queen Emma Clinic.
abstract: OBJECTIVE
  To study postpartum follow-up rates, as well as counseling opportunities, among Queen Emma Clinic patients before and after the implementation of the Queen Emma Clinic Postpartum Follow-up Initiative.
  
  
  METHODS
  This was a retrospective chart review of 221 women who received prenatal care at the Queen Emma Clinic and gave birth between April 2006 and April 2008. In April 2007 the postpartum initiative was started. The primary outcome was the number of postpartum follow-up visits. Secondary outcomes included breastfeeding, contraceptive use, depression screening and referral, follow-up screening for patien ts with gestational diabetes and subsequent pregnancy.
  
  
  RESULTS
  Postpartum follow-up rates were significantly higher after the Postpartum Follow-up Initiative (86.1% compared with 71.7%, P =.012). When comparing timing of follow-up, the first postpartum visit occurred approximately one week sooner in the post intervention group (2.96 weeks compared with 3.73 weeks, P=0.38) with no difference in timing of the second postpartum visit (6.62 weeks compared with 6.42 weeks, P=.72). In the post intervention group there were more patients breastfeeding at the first postpartum visit (28.7% compared with 16%, P=.015), as well as the second postpartum visit (28.7% compared with 12.3%, P=0.01). There were also more women using contraception in the post intervention group (84.3% compared with 71.7%, P=.009). There was no difference in depression screening or referral, follow-up screening for gestational diabetes, or timing of subsequent pregnancies.
  
  
  CONCLUSIONS
  The Postpartum Follow-Up Initiative improved postpartum follow-up rates, as well as breastfeeding, and contraceptive use.
authors.affiliation: University of Hawaii, Department of Obstetrics, Gynecology & Women's Health, Honolulu, Hawaii 96826, USA. paijong@hawaii.edu
authors.forename: Pai-Jong Stacy
authors.initials: PJ
authors.lastname: Tsai
authors.forename: Laurie
authors.initials: L
authors.lastname: Nakashima
authors.forename: Jan
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Lynn
authors.initials: L
authors.lastname: Ngo
authors.forename: Bliss
authors.initials: B
authors.lastname: Kaneshiro
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration*; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D006254:Hawaii; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data; D011181:Postnatal Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D049590:Postpartum Period; D011247:Pregnancy; D016730:Program Development; D015397:Program Evaluation; D012016:Reference Values; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult