Empowering Patient Responsibility: Part 2

Posted by Signature Care Management Team on Tuesday, January 31, 2017 in Blog

Our previous post, “The Dangerous Myth of Patient Responsibility,” discussed patient responsibility through the lens of a missed healthcare visit and the social inequities that can create barriers to accessing healthcare. Two perspectives, by a patient and provider, demonstrated how a provider may make an assumption that a patient who repeatedly misses her appointments is irresponsible and apathetic, when the reality is the patient relies on undependable public transit and does not have enough money to afford her bus fare. Neither the provider nor the patient had the information and resources they needed to achieve the mutual goal of attending prenatal appointments.

At Signature Medical Group, we have developed and implemented a successful Maternity Care Home Model that addresses these gaps in healthcare. We improve maternal and child outcomes by empowering pregnant women and addressing inequities and social determinants of health.

Addressing Inequity During Maternity Care

In our model, we utilize physician-led interdisciplinary care teams, including nurse navigators and perinatal care coordinators (master's level social workers) who are trained to identify and address a patient's behavioral health and psychosocial needs. With this perspective, now our physicians and care team not only identify barriers to access, but also ask patients how they can help. We ask how we can help our patients move to affordable housing.

We ask how we can assist our patients and their partners with job placements. We provide resources and psychosocial support our patients need to manage their healthcare and meet their life goals. We operate from a framework of patient-centered and patient-directed care, meaning our patients are the experts in their lives and inherently possess both the internal and external resources to overcome life's challenges and move to better health and overall wellness.

Impacting Health Outcomes By Breaking Down Barriers

This shift in our perspective has transformed us and we are convinced that addressing behavioral health needs and emphasizing value-based care is the key to achieve better outcomes. After implementing this model for three years, with over 2500 women in rural, urban, and suburban communities, the results have been dramatic. Preterm births, at less than 37 gestational weeks, have been reduced by 16% compared to our historical rates.

Our patients are beginning prenatal care an average of two weeks earlier. C-sections have been reduced by 21% from our historical rates. Over 86% of our patients attend 10 prenatal visits, an increase of 30% since the program began. While our patient satisfaction is now at 95%, the true impact is the numerous lives which have been transformed.

Empowering Patients Through A New Perspective

Through our Maternity Care Home Model, we have shifted our providers' perspective and empowered patients to take a more active role in their healthcare decisions. We see this concept demonstrated when we revisit April and Brad's story as participants in our model. When April called to make her first prenatal care appointment, she was connected with a Perinatal Care Coordinator, Mary.

Mary assessed April's biopsychosocial risk factors and entered her findings into the electronic medical record, where Dr. Smith was made aware that April was not getting enough nutritious food and was currently homeless, both of which impact her pregnancy. While Dr. Smith does not have the capacity to address these issues, Mary does. Mary reached out to reliable community partners and connected April to an agency that provides intensive case management, which included getting both April and Brad's birth certificates and Social Security Cards.

This step helped them obtain food stamps, housing, and more stable employment. As a result of Mary's assistance, April made it to all her appointments on time and April delivered a healthy, full term baby boy. She and Brad were back on their feet and better yet, April had a spring in her step.

Dr. Smith could hardly believe April was the same patient she had first seen. April and Brad are an example of how individual lives are transformed through our model. While April and Brad's story has been altered to protect privacy, it represents some of the challenges our patients face and how we work with them to overcome their barriers to healthcare.

Through our comprehensive Maternity Care Home Model, we help patients help themselves. For physicians, the result is an extension of their office that improves maternity outcomes and increases patient's adherence to their treatment plan. For patients, they have the best chance for a healthy full-term pregnancy and are set on a path to improve their lives for themselves, their family, and their new child. For more information on transforming maternity care, visit SignatureCareManagement.com.

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5. pregnancy
6. preterm birth