The Ohio Gestational Diabetes Postpartum Care Learning Collaborative: Development of a Quality Improvement Initiative to Improve Systems of Care for Women

Shellhaas, Cynthia; Conrey, Elizabeth J.; Crane, Dushka; Lorenz, Allison; Wapner, Andrew; Oza-Frank, Reena; Bouchard, Jo

doi:10.1007/s10995-016-2170-2

Cited by 9 publications

(9 citation statements)

References 24 publications

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“…Barriers included protected time to participate in the collaborative, few opportunities to co-design the collaborative, lack of information sharing and coordination of care between sectors, and lack of data on the sustainability of the results due to the temporary nature of the collaborative [ 58 , 81 , 82 ]. The evaluation tends to focus more on the outcomes rather than the learning methodology and associated costs.…”

Section: Resultsmentioning

confidence: 99%

Aiming for quality: a global compass for national learning systems

Sarakbi

Mensah-Abrampah

Kleine-Bingham

et al. 2021

Health Res Policy Sys

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Introduction Transforming a health system into a learning one is increasingly recognized as necessary to support the implementation of a national strategic direction on quality with a focus on frontline experience. The approach to a learning system that bridges the gap between practice and policy requires active exploration. Methods This scoping review adapted the methodological framework for scoping studies from Arksey and O’Malley. The central research question focused on common themes for learning to improve the quality of health services at all levels of the national health system, from government policy to point-of-care delivery. Results A total of 3507 records were screened, resulting in 101 articles on strategic learning across the health system: health professional level (19%), health organizational level (15%), subnational/national level (26%), multiple levels (35%), and global level (6%). Thirty-five of these articles focused on learning systems at multiple levels of the health system. A national learning system requires attention at the organizational, subnational, and national levels guided by the needs of patients, families, and the community. The compass of the national learning system is centred on four cross-cutting themes across the health system: alignment of priorities, systemwide collaboration, transparency and accountability, and knowledge sharing of real-world evidence generated at the point of care. Conclusion This paper proposes an approach for building a national learning system to improve the quality of health services. Future research is needed to validate the application of these guiding principles and make improvements based on the findings.

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Section: Resultsmentioning

confidence: 99%

Aiming for quality: a global compass for national learning systems

Sarakbi

Mensah-Abrampah

Kleine-Bingham

et al. 2021

Health Res Policy Sys

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“…improvement in postpartum diabetes screening. 15 In contrast, Vesco et al found that when health care providers were educated about a standardized guideline, including reminders to offer screening, completion of type 2 diabetes screening improved from 59.5% to 71.5%. 16 In June 2017, a retrospective chart review from 2 patientcentered medical home clinics revealed that postpartum diabetes screening was completed for only 39% of the women with GDM.…”

Section: Introductionmentioning

confidence: 96%

“…Education about the importance of postpartum diabetes screening has been recommended for all health care providers and women with GDM 14 . Shellhaas et al offered education about postpartum diabetes screening to both health care providers and women with GDM, but there was no significant improvement in postpartum diabetes screening 15 . In contrast, Vesco et al found that when health care providers were educated about a standardized guideline, including reminders to offer screening, completion of type 2 diabetes screening improved from 59.5% to 71.5% 16 …”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11][12][13][14][15][16] Other efforts to improve screening rates and reduce the risks associated with type 2 diabetes have included the use of standardized guidelines, checklists, and postal reminders for women with GDM and reminders for health care providers inserted into clinical health records. [5][6][7][8][9][10][11][12][13][14][15][16] A survey of obstetrician-gynecologists (N = 306) found that health care providers who frequently offer postpartum diabetes screening were more likely to have a clinical guideline in place compared with providers who did not frequently offer postpartum screening. 13 Lega et al found that women are 3 times as likely to be offered screening for diabetes if a checklist is on their health record (odds ratio, 2.99; 95% CI, 1.84-4.85).…”

Section: Introductionmentioning

confidence: 99%

“…Research has identified many barriers to postpartum diabetes screening for women with GDM, including loss of insurance and lack of reminders for health care providers and patients. Various combinations of reminders for women with GDM and reminders for health care providers have been used to increase the frequency of recommended screening 5–16 . Other efforts to improve screening rates and reduce the risks associated with type 2 diabetes have included the use of standardized guidelines, checklists, and postal reminders for women with GDM and reminders for health care providers inserted into clinical health records 5–16 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Team‐Based Approach to Managing Postpartum Screening of Women with Gestational Diabetes for Type 2 Diabetes

Bounds

Rojjanasrirat

Martin

2021

J Midwife Womens Health

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Introduction Approximately 6% of pregnant women develop gestational diabetes mellitus (GDM), which is a strong risk factor for developing type 2 diabetes mellitus. It is recommended that women with GDM complete a 75‐g oral glucose tolerance test (OGTT) 4 to 12 weeks postpartum to screen for type 2 diabetes. A 3‐month retrospective chart review in 2 patient‐centered medical homes found that postpartum screening for type 2 diabetes was performed in only 39% of eligible women, despite recommendations from the American College of Obstetricians and Gynecologists (ACOG) and the American Diabetes Association. Thus, a quality improvement project was initiated to improve the postpartum type 2 diabetes screening rate. Process This quality improvement project involved an education session that described current ACOG recommendations for diabetes screening. The education session included a pretest and posttest that evaluated participants’ understanding about development of type 2 diabetes after GDM. A team‐based postpartum guideline designed to enable women to complete a 75‐g OGTT at the 4‐to‐12‐week postpartum appointment was implemented. A postintervention chart review was conducted to determine the postintervention rate of type 2 diabetes screening. Outcome The mean pretest score for the clinical team was 57%, and the mean posttest score was 99%. Postpartum screening for women with GDM was improved from 39% of women for whom screening was indicated to 77% with the implementation of the team‐based guideline. Discussion The quality improvement project results demonstrated that improved understanding of ACOG recommendations combined with the implementation of a team‐based guideline significantly improved postpartum screening for type 2 diabetes. Team‐based management of care, including education of team members about the rationale for change, may also improve outcomes in other quality improvement projects.

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Postpartum Health and Wellness: A Call for Quality Woman-Centered Care

Verbiest

Bonzon

Handler

2016

Matern Child Health J

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Introduction The first 3 months after giving birth can be a challenging time for many women. The Postpartum Health and Wellness special issue explores this period, one that is often overlooked and under-researched. Methods This issue is designed to bring greater focus to the need for woman-centered care during the postpartum period. Articles in this issue focus on four key areas: (1) the postpartum visit and access to care, (2) the content of postpartum care and postpartum health concerns, (3) interconception care including contraception, and (4) policy, systems, and measurement. Results The submissions highlight deficits in the provision of comprehensive care and services during a critical period in women's lives. The research highlighted in this issue supports the recommendation that Maternal and Child Health leaders collaborate to create woman-centered postpartum services that are part of a coordinated system of care. Conclusion In order to achieve optimal health care in the postpartum period it is becoming more apparent that increased flexibility of services, cross-training of providers, a "no wrong door" approach, new insurance and work-place policy strategies, improved communication, and effective coordinated support within a system that values all women and families is required.

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The Ohio Gestational Diabetes Postpartum Care Learning Collaborative: Development of a Quality Improvement Initiative to Improve Systems of Care for Women

Cited by 9 publications

References 24 publications

Aiming for quality: a global compass for national learning systems

Aiming for quality: a global compass for national learning systems

Team‐Based Approach to Managing Postpartum Screening of Women with Gestational Diabetes for Type 2 Diabetes

Postpartum Health and Wellness: A Call for Quality Woman-Centered Care

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