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Timely and Appropriate Healthcare Access for Newborns: A Neighborhood‐Based, Improvement Science Approach
Author(s) -
Brown Courtney M.,
Kahn Robert S.,
Goyal Neera K.
Publication year - 2017
Publication title -
new directions for evaluation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.374
H-Index - 40
eISSN - 1534-875X
pISSN - 1097-6736
DOI - 10.1002/ev.20234
Subject(s) - intervention (counseling) , psychological intervention , emergency department , primary care , data collection , low income , nursing , medicine , psychology , medical education , family medicine , socioeconomics , sociology , statistics , mathematics
Newborns in low‐income families often experience delays between birth hospital discharge and the first primary care visit. Delays in primary care can result in inadequate support and education for families and may lead to emergency department (ED) visits for nonurgent conditions. Our intervention sought to reduce average age at first primary care visit to ≤ 9 days of life and reduce nonurgent ED visits by 20% among infants < 6 months old from one low‐income neighborhood in Cincinnati, Ohio. We applied improvement science to iteratively address the many family‐ and system‐level barriers to primary care. Improvement science is a structured approach to improving outcomes through ongoing data collection and examination of how specific practices affect performance. Advantages of this approach include the ability to detect incremental changes in outcomes and continuously adapt interventions over time. This chapter discusses the successes and challenges of applying improvement science to our goals.