Evidence map›Paper›PMID 38253508›Full record

ArticleAnnals of family medicine

A Mixed Methods Evaluation of a Quality Improvement Model to Optimize Perinatal and Primary Care in the Community Health Setting.

Jena Wallander Gemkow, Ashlee Van Schyndel, Renee M Odom, Ananya Stoller, Lisa Masinter, Ta-Yun Yang, Patricia A Lee King, Abigail C Holicky, Arden Handler

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Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jena Wallander GemkowAllianceChicago, Chicago, Illinois jgemkow@alliancechicago.org.
Ashlee Van SchyndelUniversity of Illinois at Chicago School of Public Health, Center of Excellence in Maternal and Child Health, Chicago, Illinois.
Renee M OdomUniversity of Illinois at Chicago School of Public Health, Center of Excellence in Maternal and Child Health, Chicago, Illinois.
Ananya StollerUniversity of Illinois at Chicago School of Public Health, Center of Excellence in Maternal and Child Health, Chicago, Illinois.
Lisa MasinterIllinois Department of Public Health, Chicago, Illinois.
Ta-Yun YangAllianceChicago, Chicago, Illinois.
Patricia A Lee KingNorthwestern University, Feinberg School of Medicine, Department Medical Social Science and University of Chicago, Pritzker School of Medicine, Evanston, Illinois.
Abigail C HolickyUniversity of Illinois at Chicago, College of Medicine, Academic Internal Medicine, Chicago, Illinois.
Arden HandlerUniversity of Illinois at Chicago School of Public Health, Center of Excellence in Maternal and Child Health, Chicago, Illinois.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMany maternal deaths occur beyond the acute birth encounter. There are opportunities for improving maternal health outcomes through facilitated quality improvement efforts in community settings, particularly in the postpartum period. We used a mixed methods approach to evaluate a collaborative quality improvement (QI) model in 6 Chicago Federally Qualified Health Centers (FQHCs) that implemented workflows optimizing care continuity in the extended postpartum period for high-risk prenatal patients.

methodsThe Quality Improvement Learning Collaborative focused on the implementation of a registry of high-risk prenatal patients to link them to primary care and was implemented in 2021; study data were collected in 2021-2022. We conducted a quantitative evaluation of FQHC-reported aggregate structure, process, and outcomes data at baseline (2020) and monthly (2021). Qualitative analysis of semistructured interviews of participating FQHC staff focused on the experience of participating in the collaborative.

resultsAt baseline, none of the 6 participating FQHCs had integrated workflows connecting high-risk prenatal patients to primary care; by the end of implementation of the QI intervention, such workflows had been implemented at 19 sites across all 6 FQHCs, and 54 staff were trained in using these workflows. The share of high-risk patients transitioned to primary care within 6 months of delivery significantly increased from 25% at baseline to 72% by the end of implementation. Qualitative analysis of interviews with 11 key informants revealed buy-in, intervention flexibility, and collaboration as facilitators of successful engagement, and staffing and data infrastructure as participation barriers.

conclusionsOur findings show that a flexible and collaborative QI approach in the FQHC setting can help optimize care delivery. Future evaluations should incorporate the patient experience and patient-level data for comprehensive analysis.

Indexed as

Public HealthQuality ImprovementContinuity of Patient CareFamilyFemaleHumansPostpartum PeriodPregnancycontinuity of patient carematernal healthmedical record linkagepostpartum periodpregnancy, high riskpreventive medicineprimary health carequality improvementregistries

Identifiers

PMID38253508
PMCPMC11233081

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.