Community Collaborations Within a Public Health System Salina - - PowerPoint PPT Presentation

Building Successful Community Collaborations Within a Public Health System

Salina – Saline County Health Department MCH Program Prenatal Collaboration Project

Objectives

• Identify one approach to collaborating with

existing community programs/partners to better reach the community’s most at risk prenatal populations.

• Identify how the March of Dimes’ Becoming a

Mom / Comenzando bien curriculums can be adapted to meet the needs of your community’s prenatal population.

• Identify potential road blocks when starting a

community collaboration of this nature.

Background

• Salina-Saline County Health Department’s (SSCHD)

Maternal Child Health (MCH) program’s focus on providing education and social support to pregnant women, new mothers, and infants in Saline County

• Routes of delivery of this education and support

have changed over time, with change in other programs and services, change with technology, culture and population, etc.

• Frustration with inability to reach targeted

population

Background

• Initiation of conversation with our FQHC about

possibility of a prenatal collaboration

• Exploration of options, i.e. “Centering

Pregnancy”, March of Dimes’ Becoming a Mom / Comenzando bien

• Shifted back to idea of “group” prenatal

education as an enhancement to traditional prenatal care model, not a replacement for

• Conversations and meetings with the March of

Dimes; grant proposal solicited

Background

• Began bringing in other community partners, i.e.

childcare partner, Wal-Mart, Senior Center

• Collaboration included SSCHD’s MCH staff

facilitating monthly group prenatal education classes at SFHCC as a part of SFHCC’s routine prenatal care

• Prenatal Group Education Collaboration Project
• fficially started July 2010, after close to two

years of conversations, brainstorming, bringing partners together, grant writing, etc.

Brief Summary of Project

• Our MCH staff overseeing the project; working

with a project manager at FQHC (and each additional site with expansion)

• Our MCH staff facilitating group education

sessions at the FQHC during the 3rd week of the month

• Residents, at the FQHC / KU Family Practice

Residency Program, participate in group sessions

Brief Summary of Project

• Ideally, “every" patient receiving prenatal care at

SFHCC will attend a monthly prenatal education class in addition to routine appointment with physician

• Part of routine prenatal care; not an optional class

(ideal)

• Program is incentive based
• Group sessions once a month for a series of 6

sessions, then restart

• Uses March of Dimes’ Becoming a Mom / Comezando

bien curriculum as it’s core

Brief Summary of Project

Topics for Sessions

• Session 1 - You and Your Pregnancy / Prenatal Care

– Content: getting to know you exercise; common discomforts of pregnancy and what you can do; why prenatal care is important; what to expect and prenatal tests; talking to your provider – Highlighted Agencies/Resources: Maternal and Infant Program (M&I); Pregnancy Service Center (PSC); OCCK transportation / G&B Enterprises; “Text-4-Baby”

• Session 2 - Pregnancy Health

– Content: healthy eating and what pregnant women need; shopping & cooking on a budget; what foods are not safe for consumption by pregnant women; why stress is a concern during pregnancy and how to control it; importance of exercise; importance of healthy relationships; partner abuse and where to get help; safe sex during pregnancy; things to avoid during pregnancy – smoking, alcohol, drugs; prescription and OTC meds.; how viruses and other infections affect the fetus; chemicals and work safety – Highlighted Agencies/Resources: WIC; Prairie Land; DVACK; SRS; OARS program; Substance Abuse programs; Ashby House; Housing Authority; Quitline

Brief Summary of Project

Session 3 - Signs and Symptoms of Preterm Labor / Labor and Delivery

– Content: knowing s/s of preterm labor, what to do, and when to see the Dr.; why the last few weeks count; inductions (medically needed vs. non-medically needed); preparation for the hospital; birthplan; s/s of labor and when to go to the hospital; what to expect at the hospital; three potential ways of having a baby; what to expect with a c-section and recovery; coping with pain – Highlighted Agencies/Resources: Expectant Parent Class (EPC); SRHC Childbirth Classes; SRHC registration form; s/s of preterm labor wallet card

• Session 4 - Infant Feeding / Breastfeeding Basics

– Content: safe feeding basics; recognizing early hunger cues; breastfeeding basics: you will not have milk at first, it will be colostrum; importance of colostrum and breastfeeding; importance of frequent feedings at breast; supply and demand; realistic expectations; positioning; common problems; where to get help – Highlighted Agencies/Resources: Saline County Breastfeeding Coalition (SCBC); La Leche League (LLL); WIC; SRHC Breastfeeding Class

Brief Summary of Project

• Session 5 - Infant Care / Happiest Baby on the Block / Period of Purple

Crying / SIDS

– Content: bonding with your baby; diapering; bathing; normal bowel patterns; knowing that crying is normal and that it will likely peak at 2-3 months; how to deal with crying; techniques for soothing a crying baby (“Happiest Baby on the Block”); SIDS: what causes it / what it is; risk factors for and ways to reduce risk factors; safe sleep practices and environment; SIDS in childcare; immunizations – Highlighted Agencies/Resources: Heartland Healthy Families (HHF); Parents as Teachers (PAT); Child Advocacy and Parenting Services (CAPS), Parent Helpline; KCSL Tip Card; Car seat Expiration flyer; Car seat Inspection flyer

• Session 6 - Postpartum Recovery / Interconception Health

– Content: realistic expectations of the postpartum period; physical changes; emotional changes; baby blues and PPD; when to see your provider; relationships; returning to work; childcare; when to have another baby; family planning options and resources; taking care of yourself; returning to pre- pregnancy (or ideal) weight and blood sugar control; vaccinations; medications; smoking, alcohol and drug use; folic acid – Highlighted Agencies/Resources: Postpartum Resource Center of Kansas (PRC); Mental Health resources in Salina; Salina-Saline County Health Dept. (SSCHD) – Family Planning, Immunizations, Childcare resources; Childcare Resource and Referral Agency; ICD; Poison Control

Brief Summary of Project

• Sessions in English and Spanish
• Sessions designed so women can enter at any

point in pregnancy: two different sessions each month, on different rotations

• Sessions are two hours long, with snacks

provided

• Sessions incorporate social support piece /

integration of community agencies & programs

Project Successes

• Invaluable partnerships created:
• CAPS – providing on-site childcare during sessions
• OCCK – transportation
• Wal-Mart – incentives “at-cost”
• Senior Center / RSVP – swaddling blankets
• Guest Presenters: Early Childhood Programs,

Pregnancy Service Center, Mental Health Center, Highway Patrol

Project Successes

• Level of support from community partners and the

lack of barriers

• Wal-Mart providing incentive items for the project at cost
• Child Advocacy and Parenting Support (CAPS) program

using United Way funding to provide quality childcare during class sessions (In first 6 mo., 72 total children – 63 Spanish, 9 English)

• Buy-in and support from SFHCC faculty and staff
• Support from SSCHD administrator and Board of

Health; also KDHE MCH program

• Interest, and commitment from, OB practices in

community for partnership expansion in year two

Project Successes

• Session discussions, sharing, and question asking

leading to:

• Patients talking to their physician and reporting

concerns

• Concerns being identified and treated, i.e. Pica, UTI,

placenta previa

• Participants learning from each other

Project Successes

• Relationships being established:
• Patients bringing sonogram pictures to share
• Staying around after class to visit
• Knowing staff at WIC appointments and Healthy Start

Home Visits and voicing their appreciation for / excitement about the classes

• Relationships between health care providers and

community agencies

Project Successes

• Knowledge gain:
• Patients reporting they are learning “so much”, even

experienced mothers and experienced breastfeeders

• Evidenced by answers on pre and post tests
• Patient not wanting to accept incentive, as “education

was enough of a gift”

• Patients bringing pregnant friends from other clinics as

“support person”

• Patient concern with transfer of care due to not wanting

to miss out on classes

Project Successes

• Behavior changes:
• Report of behavior changes on Completion Surveys;

i.e. personal health habits and contact with community agencies and resources

• Report of a “developed connection with other

pregnant women in the class, the class teacher, or

• ther social supports” on Completion Surveys
• Report of behavior change / increased support from

“support person”

Project Successes

• SFHCC (FQHC) Feedback:

– In complete support of partnership and continued commitment to collaboration – See us as helping them do their job better – Patients who attend group have reported greater satisfaction with their prenatal care – Long term evaluation of project hoped to show improved birth outcomes

Project Successes

• State recognition:
• For being a “model collaborative project” . . . Bringing

public health, prenatal care providers, community agencies, and private businesses together as partners

• Invited to speak at the Perinatal Association of Kansas

(PAK) annual conference in July

• National recognition:
• Chosen “Best Practice” model for the March of Dimes

Western Region (28 states), medium sized chapters

Lessons Learned

• First Lesson: To have a real impact on birth
• utcomes in our community, need to expand to
• ther clinics to reach larger numbers . . . . Needs

to be community wide

• SFHCC numbers of deliveries per month are

about 15-23% of what other OB clinics in Salina are delivering . . . . Or about 8% of total monthly deliveries

• Now in phase two: Expansion to all OB

practices across community

Lessons Learned

• Most are process oriented, i.e. registration for

classes, who is responsible, solid process in place

• Hold all partners (including self) accountable
• Changes made based on careful balance of

feedback from: participants, survey of patients not attending group sessions, partnering agency

A Bit About “Phase Two”

• Project manager at FQHC, Dr. Allred,

instrumental in expansion

• Lunch/breakfast presentations at each of the 3

OB clinics and 1 Family Practice clinic that provides OB care

• All in full support and committed to

collaboration

A Bit About “Phase Two”

• Our MCH staff continue to oversee project and

will work with a project manager at each clinic

• Group sessions for all other clinics will convene

in one neutral location, but brochures, flyers, calendars, etc. will have each individual clinic’s logo

• Continue to be held 3rd week of month; more

session options (group times)

What This Means To You

• You can do this too!! 

What This Means To You

• We all have dwindling resources
• Only makes sense (“cents”) to

combine them!

What This Means To You

• Look at already existing

relationships

• Look for the low hanging fruit
• Look to form new partnerships . . .

that should have been there all along

What This Means to You

• Don’t reinvent the wheel
• Think outside the box! It doesn’t

have to be how we’ve always done it.

• Look for sustainability

What This Means To You

• Yes, this is some of what you are

already doing in MCH

• The collaboration will help you do

it BETTER!

• Questions?

Thank You!

• Stephanie Wolf, RN, BSN, CBE

MCH Coordinator Salina-Saline County Health Department swolf@sschd.org