Unlocking the power of clinical data to elevate perinatal care:
Finding solutions in a rural health care setting
Introduction
One of six acute care hospitals that comprise a larger parent system, a 61-bed community hospital in rural New Mexico serves a patient population of 69 percent racial or ethnic minorities and 64 percent non-native citizens with a median income 12 percent below the national average.
Like most acute care hospitals, this rural-based facility participates in the Hospital Inpatient Quality Reporting Program by Centers for Medicare and Medicaid. The reporting revealed a growing compliance concern with the perinatal care measure, PC-05. A new team member analyzed the related clinical data to identify the cause of the increasing fallouts. Among her findings, she determined that only 20 percent of new mothers were breastfeeding, a key component of perinatal care.
To help confront the issue, the facility’s team engaged Q-Centrix clinical data experts to document elements within their proprietary software, the exception reporting tool, to gain greater context and clarity on why patients were not breastfeeding. Ultimately, their analysis revealed a persistent lack of publicly accessible perinatal care information among the population and the absence of a lactation consultant as the primary contributing factors.
To address the challenge, the rural hospital turned to community partnerships to add patient education related to breastfeeding. Outreach included education for expectant and new mothers about the benefits of breastfeeding and the team employed a rapid change management process to test the efficacy of their solutions.
Goals:
- Improve perinatal care for their served population
- Increase breastfeeding rates resulting in reduced fallouts and increased compliance
Challenges:
- Documentation lacked the detail needed to understand fallouts
- The data pointed to perinatal fallout occurring, but not the reason(s) it was occurring. It was not initially possible to engage the data further to test solutions.
- Small, underserved, rural hospital with limited finances
- Served population’s income was 12 percent below the national average
Over 60 million Americans rely on rural hospitals for their care, yet a record number closed in 2020.
Solutions:
- System had an enterprise partnership with a third-party that delivered access to experienced and organized clinical data experts
- Used third-party’s exception reporting software to identify why patients were avoiding breastfeeding
- Senior Manager set quality improvement goals for perinatal care based on data found in documentation
- Partnered with local organizations to educate expectant and new mothers in the area regarding perinatal care (such as breastfeeding)
- Sent expectant and new mothers resources from organizations
- Observed which partners were most willing to work with clinical data goals set by Senior Manager of Quality and evolved partnerships based on goals
Outcomes:
- Detailed, accessible documentation and data with little administrative burden
- Lower fallout from perinatal cases
- More expectant and new mothers educated on perinatal care
- Best practices proposed and exchanged with local organizations through a community maternal health committee
- More patients connected to local resources and groups
- Further investment from system based on results and creative solutions
Conclusion
Community hospitals benefit from partnerships that grant them access to a large pool of expertise, as recruiting talent can be a challenge in rural communities. Smaller hospitals with less than 100 beds, also benefit from fewer administrative hurdles. By combining these unique strengths, similarly sized health care providers often possess greater agility for change testing and process improvement.
A prime example of this scenario, the hospital discussed in this study accessed Q-Centrix’s clinical data experts and industry-leading exception reporting technology to help them identify opportunities for improvement in perinatal care. The hospital then adapted its processes quickly to benefit its patients and operational efficiency.