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Dear friends,
LA Best Babies Network's Healthy Births Care Quality Collaborative recently held its final Learning Session. The hard work and commitment of the Collaborative has led to many successes and improvements in birth outcomes for the 10 clinics. The Network congratulates the Collaborative on its impressive achievements.
Your friends at LA Best Babies Network
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Bringing in the
Harvest
Healthy Births Care Quality Collaborative
Learning Session 5
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The LAC+USC Diabetes Pregnancy Clinic Team |
On February 24th,
LA Best Babies Network held its fifth and final Learning Session, at the
California Endowment in downtown Los Angeles, to share and celebrate the
accomplishments of the 10 teams that make up the Network's Healthy Births Care Quality Collaborative.
The Session, aptly named "the Harvest", was the culmination
of 20 months of work and dedication on the part of the 10 L.A. County clinics, and
the Network's Care Quality Team, Jan French, Beiney Nercissien,and Lorena Wagner. The Collaborative committed itself to continuous care quality
improvement through the implementation of evidence-based practices and
meticulous data collection and reporting.
The results speak for themselves.
Every clinic boasted dramatic improvements in screening rates for depression,
diabetes, and increases in client breastfeeding rates, while providing a high
standard of comprehensive perinatal care, respectful of every family's cultural
background.
In the early days of the Collaborative, some clinics worried that screening every
patient for depression in every trimester would become overwhelming--that they were not equipped to meet the needs of depressed women for
further assessment and treatment. As it turned out, the
majority of positive screens revealed only mild depression, and once the
conversation had been started, women then opened up about other
difficulties they were facing--practical issues like food insecurity, baby
supplies, housing, transportation, and unemployment--that could be alleviated in
practical ways, through referrals to community resources.
At the other end of
the depression spectrum, it became clear how vital universal screening really
is when two clinics each identified a patient so severely depressed that she had made a suicide plan. In each case, the patient's depression would not have come
to light were it not for the routine screening.
The
Collaborative comprises Watts Healthcare Corporation; St. John's Well
Child
and Family Center; Northeast Valley Health Corporation; To Help Everyone
Clinic, Inc. (T.H.E); LAC+USC Medical Center Diabetes Pregnancy Clinic;
Clinica
Msr. Oscar A. Romero; Arroyo Vista Family Health Center; Comprehensive
Community Health Centers in Glendale; St. Mary's Medical Center-OB
clinic; and
South Central Family Health Center.The 10 teams met monthly by conference call, and in person every three to six months over the
course of the Collaborative, to share their ideas and experiences. At this final session, the teams took the opportunity to look back on the
project in its entirety and identify lessons for the future.
The groups identified effective procedures and made strategic plans to sustain
their achievements.
The speakers who
facilitated smaller breakout sessions included Dr. Lynn Yonekura,Executive
Director of L.A Best Babies Network; Jan French, CNM, MS, the Network's
Director of Programs; Dr. Carolina Reyes,the Network's Principal Investigator;
Annette Rexroad, Ph.D.; and Jennifer Ustianov, RN, BSN, IBCLC.
One clinic described
their successful prenatal support group for women and their partners, which, at
the request of the participants, now extends beyond the prenatal period. A
mental health therapist for the clinic described how a woman in the support
group had been in crisis after her partner left her, days before her delivery
date. "Everyone in the group rallied around her," continued the CPSP
coordinator for the clinic. "She would have plummeted into a deep depression,
but instead she was uplifted."
Another clinic was
proud to report that its screening rate for depression is now up to 80% for
each trimester. One moving case involved a pregnant teen who came into the
clinic having had no prenatal care. After scoring high on a depression
screening assessment tool, the PHQ-9, she was immediately referred to a social
worker, who uncovered that the baby's father had left her, and that her mom
wanted her to move out unless she gave up the baby for adoption. After the
teenager and her mother received counseling, the relationship improved, and the
young woman kept her baby.
Another happy
ending was reported involving a pregnant woman who scored high on a depression
assessment, leading to the discovery that she was living in a bug-infested apartment,
and her husband was unemployed. The clinic staff referred her to a community
group that found her family a clean, affordable apartment, and the woman's
depression abated.
The groups agreed
that critical tools for providing high-quality care included the PHQ-9, educational
materials for expectant and new parents, and a system of reminders and checklists
for scheduling assessments for infections, smoking, substance use,
nutrition, and depression.
All agreed that in
spite of their impressive achievements, there was still work to be done. For
example, the rate of new mothers returning for their 6-week postpartum checkup,
while it has shown improvement, remains below the target rate.
Near the end of the
session, the participants named the essential ingredients for continued care
quality improvement. These include a well-thought out plan with clear goals,
identification of community resources, clear definition of roles among the
clinic staff, the sharing of information, cooperation and commitment to the
effort, scrupulous data collection, leadership involvement, adapting to change,
ongoing staff training, and the celebration of success.
Learn more:
LA Best Babies Network's Care Quality Collaborative
See more photos from the event
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