A Systems Intervention for the Transition of Postpartum Women to Primary Care

The Institute of Medicine (2001) describes the United States’ healthcare system as poorly organized and difficult for patients to navigate. Patients are often lost during the transition between providers, failing to establish subsequent care (Thomas, 2015). Gaps in care lead to worsening conditions that result in billions of dollars in healthcare costs (National Quality Forum, 2016). Following discharge from the care of the obstetrician, postpartum women should establish care with a primary care provider (American College of Obstetrics and Gynecology, 2016). The American College of Obstetrics and Gynecology recommends that postpartum women transition to a primary care provider within the year following childbirth (Pai-jong, Nakashima, Yamamoto, Ngo, & Kaneshiro, 2011). Less than 33% of women nationally adhere to this recommendation (John Hopkins Medicine, 2014); less than 5% of women within the host clinic transitioned to a primary care provider. This project aimed to improve the transition of postpartum women, ages 18 to 44, to a primary care provider. The primary objective was to increase the number of postpartum women who scheduled and attended a primary care provider appointment within 2 months of delivery. The intervention included patient information material, staff training, and a process for establishing care with a primary care provider. Between June 12, 2016, and August 15, 2016, 27 women met the inclusion criteria. Following the intervention, 23 women (82%) scheduled a primary care provider appointment, and 12 women (44%) attended the appointment. Results suggest that a combination of provider counseling, patient education, and assistance with the transition process can influence patient adherence to expert recommendations for establishing subsequent care.