Psychosocial Support, Newborn Readmissions, and Postpartum Follow-up

Background. Women and their infants are being discharged as soon as 24 hours after giving birth without proper follow-up care. The Maternity Department at San Antonio Community Hospital established the Family Care Center (HBFCC) in November 2000 in response to a higher than expected newborn readmission rate, shorter maternity hospitalizations, and a lack of postpartum follow-up. A comprehensive program was offered to support new families in the form of developmental assessment and intervention, breastfeeding, infant and toddler nutrition, health promotion and education, and referrals to appropriate agencies when indicated. In 2004, due to inadequate funding, the hospital reduced the intervention to a postpartum clinic that included limited breastfeeding support 2 weeks following birth. Purpose. The purpose of this study was to determine if there is a positive relationship between the degree of psychosocial support offered (comprehensive, limited, or none) by healthcare providers and the rate of normal newborn readmissions. In addition, a cost-benefit analysis was performed to compare the costs of the intervention to the costs for normal newborn readmissions to establish whether such interventions are worthwhile from an economic viewpoint. Design and Method. The study utilized an interrupted time series design with a partial reversal of the intervention. The study included a retrospective analysis of a secondary dataset of normal newborn readmissions at SACH at baseline, 1 year prior to the onset of a comprehensive psychosocial intervention for new mothers and babies (1999-2000), the 4 years during the comprehensive psychosocial intervention (2001- 2004), and 2 years post-intervention during a partial reversal or limited psychosocial intervention (2004-2006). The data were collected in fiscal years from July 1 - June 30 to coincide with the cost-benefit analysis. Participants included normal newborn births or a diagnosis related group (DRG) of 391 froom July 1,1999-June 30, 2006. A one-way ANOVA was conducted to determine if there were significant differences in average costs per patient across all three time periods. Results.There was a significantly lower readmission rate 1.0% (p \u3c .001) compared to baseline (2.3%), or during the limited psychosocial support intervention time period (2.3%). While there was no significant difference in the average cost per newborn readmitted across the three study time periods, during the comprehensive intervention time period, the average costs of a normal newborn readmission were significantly lower ($4,180,p = .041) for those who received the intervention compared to those who did not ($5,338). The two-way ANOVA comparing the average costs per newborn readmission across all three time periods showed a significant interaction (p = .04) across limited and comprehensive time periods and whether or not the individual received the intervention. The average costs of normal newborn readmissions for those receiving the intervention during the limited time period was $4,845 compared to those not receiving the intervention ($3,785). There was a cost-benefit of $513,540 due to fewer readmissions during the comprehensive psychosocial support time period but it did not exceed the cost of the intervention attributed to care in the first 28 days postpartum ($1,183,600). Significance to Health Education. With healthcare costs continuing to increase and early discharge programs following delivery a common practice, understanding the potential effects of psychosocial support in a postpartum program is essential. Providing comprehensive follow-up for new mothers in the postpartum period can reduce normal newborn readmissions and potentially lower the average charges for newborn readmissions for those who receive psychosocial support

Bold leadership is needed for transforming health care.

Health care in the United States is going through significant changes and is at the forefront of the political landscape. While the health care debate rages on, leaders need to forge ahead and continue to work towards population-based health care and investing in their communities in a fiscally conscious way. Many innovations are happening but more needs to be done, especially in upstream services improving the health of the community. Research shows that investing in social care services and community-based investments results in lower health care expenditures and better health outcomes. Efforts should be placed on exploring a blended medical/social model of care while considering blended funding sources wherein the community needs to be active participants in this explorative process

A New Day: A True Story of Faith, Healing, and Miracles

Dora Barilla had the perfect life; a great job, a handsome firefighter husband, two beautiful daughters and a house in the suburbs. But on March 15, 2005, her world was turned upside down. While on a routine call, husband Tom Barilla suffered a traumatic brain injury in a horrific collision that nearly killed him, destroying Dora\u27s perfect world.In painstaking detail, Dora recounts the days sitting by Tom\u27s bedside as he lay in a coma, the numerous surgeries he endured, the endless hours of rehabilitation and weeks of nasty litigation that pitted the family of firefighters and the city against the California Highway Patrol and the tour bus company that crashed into Tom\u27s fire engine.Dora tells the story of her struggle to maintain optimism for her family and friends as well as keep her own sanity. Ultimately, with faith and understanding, Dora is able to accept the challenges of her new world and embrace a new day.https://digitalcommons.pepperdine.edu/alumni_books/1062/thumbnail.jp

During and After Pandemic: How Hospitals Can Help Communities Respond to Homelessness

According to conservative estimates, more than 21,000 people experiencing homelessness could be hospitalized due to COVID-19. For those who recover, where will they go? Hundreds of thousands more could be infected — without homes, where will they stay? Without safe ways to care for people without homes, how will communities prevent the virus from spreading? What will happen to unsheltered people when the pandemic threat is diminished? State and local leaders, public health departments and nonprofits have rallied to answer these questions with swift action. In California, the governor and mayors are now working to secure up to 15,000 hotel rooms to provide safe spaces for people experiencing homelessness. In Washington, Seattle and King County have created new 24/7 shelters and other places for homeless individuals to stay while recovering from COVID-19. Early lessons from these communities show us how political will and coordinated cross-sector action can save lives. Hospitals can strengthen these heroic community-led efforts

Facebook Live: How Providence is Helping in the Community During the COVID Pandemic

Join Providence\u27s Laurie Kelley, Chief Philanthropy Officer as she talks with Dora Barilla, VP of Community Investment about how Providence is helping in the community during the COVID pandemic. They will discuss programs Providence has in place, programs that Providence supports, and how you can help

Facebook Live: Housing Solution Community Partnerships: Catholic Charities+

People experiencing homelessness are at high risk for infection, suffering severe symptoms, and dying from COVID-19. Join this live discussion to learn about how Providence partners Catholic Charities are helping to create solutions to the crisis