| Description |
Creating a Pregnancy Nurse Care Manager Model in a Community ClinicGrowth in rates of chronic health conditions and fragmentation of care in the United States healthcare system creates a demand for change in how health care is delivered (WHO, 2005; Luther et al., 2019). Currently, healthcare providers are focused on treating acute illnesses and are not well-prepared to manage chronically ill patients' care or provide the necessary education (WHO, 2005). Care fragmentation correlates with high healthcare costs, lack of care coordination, and poor patient outcomes (Cropley & Sanders, 2013). The Patient Protection and Affordable Care Act (ACA), created by the United States Office of the Legislative Counsel(2010), includes healthcare reform to improve healthcare quality and healthcare costs. It has provided funding for new care approach models to achieve its goals, including a patient-centered medical home (PCMH), which gives patients care by the same providers and a healthcare team that involves a care coordinator, who is typically a nurse (Henderson et al., 2012). According to Rakover (2016), in the article, "The Maternity Medical Home: The Chassis for a More Holistic Model of Pregnancy Care," the PCMH model has been adopted as a foundation by many health systems in the U.S. that want to improve the quality of care they provide, and it has been adapted into specific populations, including obstetrics. The PCMH foundational model developed for these maternity patients is called the Maternity Medical Home. Maternity Medical Home models aim to improve maternity care quality, improve birth outcomes, and provide continuity of care (McCoy, 2013). The Maternity Medical Homes operational elements, which include: standardized risk assessment that helps identify a woman'sneeds; focus on getting prenatal care by the first trimester; care coordination by a nurse or other health care provider to ensure that a pregnant woman receives all necessary services; standardized care pathways that target common risk factors for poor birth outcomes and ensure that each woman gets all the care that is recommended; elements that provide enhanced access to care, such as expanded hours and improved ability to contact providers; and patient-centered care. Other components to incorporate into Maternity Medical Homes includes care throughout a woman's childbearing years or facilitating the transition to different care settings (Rakover, 2016). |
