Getting Started

OB-babies-1

Choosing your OB group healthcare team:

Caring for pregnant patients can be complex. Pregnant patients often have concerns and needs beyond the routine medical aspect of their prenatal care. There may be financial concerns, behavioral concerns, or even social concerns. The OB provider may not have the skills or time to address all of these concerns and studies support that socioeconomic stressors can negatively impact obstetrical outcomes.

Given these factors, choosing various healthcare professionals to be a part of the OB group team provides a more “wrap around” view for the OB group visits. The following healthcare professionals are suggested to be a part of your OB group healthcare team if available in your setting:

• OB providers
• Prenatal Care Coordinators
• Nurses
• Lactation consultants
• Social Workers

In our model, we have:

OB providers – Attendings and Family Medicine residents
Prenatal Care Coordinators
Nurse – area of focus is community medicine

Partnering with your Organization and the Community:

Working with your healthcare organization can be helpful in many ways. Some organizations will want to review the plans for an educational group event prior to implementation – so we recommend speaking with your leadership about your desire to design and implement an OB group visit. Your organization may have personnel who have experience in planning and executing group activities. Your organization may have funding to help with innovative patient activities.

Working with your community can also be an avenue for resources and support. Your community health department often engages in patient education and may have already designed educational material that could be used in your groups.

In our model, we have organizational approval and support of our OB group visits. In addition, our local health department has helped with educational materials. Our community hospital has supported our work – they have helped us secure grants to help fund this project and provided access to healthcare members to have them participate in our OB group visits (ex. a hospital dietician came to give one of our OB group visit talks).

Organizing a focus group for needs assessment:

Every patient population has different needs for their healthcare. We recommend putting together a focus group to discuss their needs and their ideas of needs of pregnant women in their community. Talk with OB providers in your organization and have them identify 3 or 4 pregnant patients that they think would be interested in participating in a focus group. We recommend inviting 15 – 20 pregnant patients for a one time focus group encounter – lasting about 1 hour. At this focus group, explain what you are planning to initiate – an OB group visit program; explain why you are starting this program – to provide an opportunity to deliver educational topics relevant to pregnant women in an informal format in order to help improve obstetrical outcomes; and finally solicit their views.

Things to ask the focus group:
• Would this program be something they would feel is worthwhile to attend/valuable
• How often should the group meet – weekly, monthly, quarterly
• What time of day would best – morning, lunch hour, after work, evening
• What day of week would be best
• What topics would they want to hear about

In our model, our focus group told us:
• This program would be something they would attend
• Monthly would be best
• Early evening/after work would be best
• No longer than an hour in length
• Suggested topics – nutrition, breast feeding, body changes
• Need to serve pregnant women a snack/meal
• Of note we invited about 15 women and only 6 attended our focus group

Funding sources:

Any project will have expenses, even if personnel are volunteering their time. The first step to securing funding support would be within your organization. Again with gaining your organization’s support to start this program a discussion would need to involve financial support. This may be a small amount if only to provide refreshments to participants and monies to cover invitations. In addition, community organizations may also be approached for financial support – such as hospital charity foundations. Grant funds can also be explored.

In our model, we started with voluntary staff and monies from our organization to cover refreshments. Mailed invitations were done through our clinic via the same mechanism to mail any other clinical information to patients. We eventually applied and were awarded a $200,000 grant to expand this program.