Improving prenatal care and continuity for west county patients

Longitudinal Community Medicine Chris Zamani MD

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

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

Research Question

• Why are prenatal patients in west county choosing to deliver at ABMC instead of CCRMC?

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

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

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

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