title: The Ohio Gestational Diabetes Postpartum Care Learning Collaborative: Development of a Quality Improvement Initiative to Improve Systems of Care for Women.
abstract: Objectives To improve clinical practice and increase postpartum visit Type 2 diabetes mellitus (T2DM) screening rates in women with a history of gestational diabetes mellitus (GDM). Methods We recruited clinical sites with at least half of pregnant patients enrolled in Medicaid to participate in an 18-month quality improvement (QI) project. To support clinical practice changes, we developed provider and patient toolkits with educational and clinical practice resources. Clinical subject-matter experts facilitated a learning network to train sites and promote discussion and learning among sites. Sites submitted data from patient chart reviews monthly for key measures that we used to provide rapid-cycle feedback. Providers were surveyed at completion regarding toolkit usefulness and satisfaction. Results Of fifteen practices recruited, twelve remained actively engaged. We disseminated more than 70 provider and 2345 patient toolkits. Documented delivery of patient education improved for timely GDM prenatal screening, reduction of future T2DM risk, smoking cessation, and family planning. Sites reported toolkits were useful and easy to use. Of women for whom postpartum data were available, 67 % had a documented postpartum visit and 33 % had a postpartum T2DM screen. Lack of information sharing between prenatal and postpartum care providers was are barriers to provision and documentation of care. Conclusions for Practice QI and toolkit resources may improve the quality of prenatal education. However, postpartum care did not reach optimal levels. Future work should focus on strategies to support coordination of care between obstetrical and primary care providers.
authors: The Ohio Department of Health, 246 N. High Street, Columbus, OH, 43215, USA. cynthia.shellhaas@osumc.edu.|The Ohio State University College of Medicine, Columbus, OH, USA. cynthia.shellhaas@osumc.edu.
authors: Cynthia
authors: 0000-0001-9346-7432
authors: C
authors: Shellhaas
authors: The Ohio Department of Health, 246 N. High Street, Columbus, OH, 43215, USA.|Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors: Elizabeth
authors: E
authors: Conrey
authors: Ohio Colleges of Medicine Government Resource Center, 150 Pressey Hall, 1070 Carmack Road, Columbus, OH, 43210, USA.
authors: Dushka
authors: D
authors: Crane
authors: Ohio Colleges of Medicine Government Resource Center, 150 Pressey Hall, 1070 Carmack Road, Columbus, OH, 43210, USA.
authors: Allison
authors: A
authors: Lorenz
authors: The Ohio Department of Health, 246 N. High Street, Columbus, OH, 43215, USA.
authors: Andrew
authors: A
authors: Wapner
authors: The Ohio State University College of Medicine, Columbus, OH, USA.|Center for Perinatal Research, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
authors: Reena
authors: R
authors: Oza-Frank
authors: The Ohio Department of Health, 246 N. High Street, Columbus, OH, 43215, USA.
authors: Jo
authors: J
authors: Bouchard
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008403:Mass Screening; D009820:Ohio; D010349:Patient Compliance; D011181:Postnatal Care / Q000706:statistics & numerical data*; D049590:Postpartum Period; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D058996:Quality Improvement
keywords: Gestational diabetes; Postpartum care; Quality improvement