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Rural Health Care Conference CenteringPregnancy® Model for Prenatal Care Sara Long Dec. 8, 2011
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Transcript of Long
Rural Health Care Conference
CenteringPregnancy® Model for Prenatal Care
Sara Long
Dec. 8, 2011
Centering Pregnancy Model
for Prenatal Care
Thirteen essential
elements define the
Centering model of care
Care is normalized Privacy is assured
1. Health assessment occurs
within the group space
2. Participants are involved
in self-care activities
3. A facilitative leadership style
is used
4. Each session has an overall plan
Birth Preparation
Nutrition & Infant
Feeding
Stress
Reduction
Infant
Development
Comfort &
Safety
“I’m learning that it
doesn’t matter what
we don’t talk about
because we’re
talking about what
matters to the group”
5. Attention is given to the general
content outline; emphasis may vary
6. There is stability of
group leadership Continuity of care Trust
Gro
up
his
tory
7. Group conduct honors the
contribution of each member
8. The group is conducted
in a circle
9. Opportunity for socializing
is provided
11. Group size is optimal
to promote the process
12. Involvement of support people
is optional
Anything we want to see improved….benchmarking
Patient experience
Attendance for prenatal care visits
Breastfeeding rates
Birth outcomes – gestational age and
birth weight
13. There is ongoing evaluation
of outcomes
96-97% of all women polled state they prefer receiving their prenatal care in group
References:
Ickovics JR, Kershaw TS, Westdahl C et al. Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstetrics & Gynecology. 2007; 110(2):330-339.
Cooper LG, LMSW; Gooding JS, BS; Gallagher J, RN, EdM, MPA; Sternesky L, MPA, Ledsky R, MBA; and Berns SD, MD, MPH. Impact of a family-centered care initiative on NICU care, staff and families. Journal of Perinatology 2007; 27: S32-S37
Grol, R., & Grimshaw, J. . From best evidence to best practice: effective implementation of change in patients’ care. The Lancet 2003; 362, 1225-1230.
Peterson AA, Berns SD, Gooding JS, et al. Meeting the Needs of Pregnant Women and Babies in a Disaster: The Role of Voluntary Nongovernmental Health Organization. Journal of Emergency Management 2007;5(1):41-46.
Words from the Wise*
Success factors in sustaining groups:
1. Dedicated, appropriate space
2. Committed administration support
(including line-items in the budget)
3. Centering coordinator with released
administrative time
4. Commitment to “opt-out”
*Sharon Rising, CNM, MSN,
Executive Director, CHI
Centering Healthcare Institute
1. Centering Site Readiness Visit
2. Initial Training
3. Reporting forms
4. Consultation on system re-design
5. Site visit and approval
Success factors in
management & funding
Lancet: From best evidence to best practice:
– Identifies 11 frequently used interventions,
4 directly relevant to Centering Pregnancy:
• Educational strategies
• Multi-professional collaboration
• Patient-mediated interventions
• Combination of interventions
Success factors in management
& funding
What do funders want:
• Outcomes
• Visibility/Recognition
• Outcomes
• SMART Objectives
• Outcomes
• Sustainability Plan
March of Dimes Involvement Our goal: in Virginia, to reduce preterm birth rates,
especially among pregnant population
at high risk of preterm birth.
1. Increase the number of sites and providers offering CP.
2. Improving fidelity of CP delivery to the essential elements
of the model.
3. Enrolling more pregnant women in CP.
4. Maintain women’s satisfaction with care.
MT
WY
ID
WA
OR
NV
UT
CA
AZ
ND
SD
NE
CO
NM
TX
OK
KS
AR
LA
MO
IA
MN
WI
IL IN
KY
TN
MS AL GA
FL
SC
NC
VA WV
OH
MI
NY
PA
MD
DE
NJ
CT RI
MA
ME
VT
NH
AK
HI
DC
2008 March of Dimes chapter-funded
Centering Pregnancy® grants – In Blue
Assessment of
MOD-funded projects
1. Expand National Office and chapter collaboration to
develop, deploy, and evaluate CP training, TA tools, and
models and to disseminate information about CP successes
to stakeholders.
2. Build informal networks of providers at the chapter level,
to engender peer-to-peer learning.
3. Develop MOD website(s) that provide access to extensive
information about ongoing TA and coordination effects;
evaluation findings; and funding opportunities.
4. Advance CP evaluation by standardizing indicators, data
collection tools, and reporting formats.
Planning, beginning in the first year
Staff buy-in
Funding – external and internal
Enrollment
Evaluation -- process and outcome
March of Dimes survey of CP providers identified
these top sustainability success factors:
March of Dimes funding
• Provide funding for basic and advanced provider
training workshops;
• CP site infrastructure, materials, supplies, and
staff; and
• Provision of coordination and technical assistance,
including assistance with evaluation.
Reporting required
for MOD funding
1. Patient demographics.
2. Patient attendance.
3. Date of first session.
4. Patient satisfaction/self-evaluation.
5. Fidelity of CP core elements.
6. Outcome Variables.
Long-term commitment
1. Provide support for mature sites for ongoing staff training.
2. Work with grantees to ensure sustainability.
3. Support TA assistance and coordination for CP sites.
4. Support and/or collaborate in research efforts that
examine benefits, cost neutrality, and/or cost effectiveness
of CP, and help to disseminate the findings to diverse
stakeholders.
5. Advocate directly for additional support for CP with other
public and private funders, policymakers, insurance
companies, and others.
Virginia Projects VCU
Family Maternity Center of the Northern Neck
Southern Dominion Health System, Inc.
Johnson Health Services
St. Francis Family Medicine Center
Eastern Virginia Medical School
Riverside Family Practice
Augusta Health Care for Women
Community Memorial Healthcare
Three Rivers Health District
Richmond City Health District
Holston Medical Group
Shenandoah Women’s Healthcare
Southampton Memorial Hospital
Manassas Midwifery
March of Dimes
• Funding ($3,000 - $35,000)
• Consultation and TA
• Advanced Training by CHI
• CP Peer to Peer Network
Q & A
For questions about the model
or funding opportunities, contact:
Sara Long
(804) 968-4120
