Improving prenatal care and continuity for west county patients
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Improving prenatal care and continuity for west county patients
Longitudinal Community Medicine Chris Zamani MD
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Background
• West county residents (Richmond and North Richmond) have historically had a hard time getting the required number of continuity deliveries.
• Many prenatal patients choose to deliver at Alta Bates Medical Center.
• Alta Bates and CCRMC are equidistant from Richmond
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Defining the problem
• From a patient perspective: – Trusted providers not a part of the delivery
process• From a resident perspective: – Difficulty meeting continuity delivery
requirements• From an institutional perspective:– Loss of potential revenue from deliveries and
perinatal admissions
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Research Question
• Why are prenatal patients in west county choosing to deliver at ABMC instead of CCRMC?
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Hypothesis
• There are a few main reasons why prenatal patients in west county are not coming to CCRMC to deliver, these include:– Lack of reliable transportation from West County
to Martinez
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Hypothesis
• There are a few main reasons why prenatal patients in west county are not coming to CCRMC to deliver, these include:– Lack of reliable transportation from West County
to Martinez– Richmond culturally aligned with
Oakland/Berkeley more so than Martinez/Concord
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Project Goals
• To design a survey tool that will accurately identify reasons why west county prenatal patients are not choosing to deliver at CCRMC
• To choose one or two barriers identified from the survey that can be realistically addressed.
• To conceptualize and implement interventions to address the problem
• To measure impact on west county deliveries of the implemented measures
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Project timeline• Phase 1
– Conduct survey, identify problems and reasonable interventions• Phase 2
– Present interventions to appropriate stakeholders (care coordinators, hospital admin, county sups. Etc.) to gain institutional support for enacting targeted interventions
• Phase 3– Gather data on prenatal continuity delivery rates from RHC and
NRCH– Analyze data for a clinically significant increase in continuity
deliveries after the implemented interventions