Planning the OB Group Visit

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Who should you invite?

The first step is to decide whether your OB group visit series will be designed for women of approximately the same EDC (Estimated Date of Confinement) or women of any EDC. There are advantages and disadvantages to both. In a group of women that are due to delivery at approximately the same time, the content can be more directed at phases of pregnancy and the content can be built upon previous groups – this is an advantage since all the women in the group will be experiencing the same time sensitive concerns. In a group of women that have random delivery dates, women have more of an opportunity to teach and support each other. For instance, if discussing drinking the glucose load for a 1 hour glucose tolerance test, a woman who has already done this test can lend first hand information and support to the woman who has yet to take it. Another factor to consider is the size of your obstetrical practice. Are there enough pregnant women around the same due date to make sense with the resources you have to make this a practical program?

In our model, our obstetrical volume can be quite variable. We also had limited personnel to participate. If we were to have organized our OB group visits by due dates, we could have a maximum of 2 – 10 pregnant women in a cohort. This was not practical given our resources, so we designed our OB group visit series to include any pregnant women in our practice regardless of due date. This maximum number could be anywhere from 40 – 60 at any given time.

How many patients to invite

Deciding on how many patients to invite will depend on several factors. First, what sort of atmosphere are you trying to achieve? Do you want a smaller group to lend itself to a more informal and perhaps supportive feel? Do you want to reach as many people as possible and plan for a larger auditorium/conference feel? Second, what is likelihood of your patients participating in events outside of their office visits? Do you have patients that attend other clinic events? In general, it would be prudent to invite 10 – 20% more people than what your ideal group size is initially until you get a sense of the attendance attitude of your patients. You may even consider surveying your pregnant women at office visits whether they would attend this sort of program and use that information to help guide you.

In our model, we invite all of our pregnant women every month – approximately 40 -60 women and we consistently will have a 25 – 30% attendance rate.

Location/size of room

You will either need to decide the amount of people you want at your groups and find a location that will accommodate this or know the location and size of room you want to use and that will dictate the maximum number of participants.

If the decision is to have a smaller group, some possible locations depending on your clinic:
• A large exam or procedure room
• Clinic kitchen or break room
• Clinic meeting room
• Clinic lobby

If the decision is to have a larger group, some possible locations depending on your clinic:
• Clinic meeting room
• Clinic lobby
• Hospital meeting room
• Community resources
• Community center
• School auditorium
• Community church
• Community health club

In our model, we started in our clinic’s meeting room. This worked well until we started having a larger attendance. We then moved the location to our lobby, this was an easy transition as our visits started at 4:30 pm and our last patient appointments were at 4:15 pm. We also made every effort to get those last patients in exam rooms quickly and organized the seating in one area of our lobby to create a separate environment. With the construction of a new clinic, we then held our group visits in our multipurpose education room – a room attached to our clinic just off of our lobby. This room is easy to access, near restrooms, near our kitchen and does not allow access to the main clinic or physician offices.

Making the schedule of the OB group visits

You need to decide whether this will be a finite educational series or a continuous one. If your model is to have all women of similar due dates, it may be prudent to start with one cohort and meet throughout their pregnancy and end with their collective deliveries. If your model is to have women of any due date, you could still have a finite series. Either way, if a finite series is chosen, it should be clear to the prospective participants that this is a finite series and whether they are expected to attend all or may attend sporadically – this will depend on your chosen topics (this will be discussed next). Choosing a finite series may lend itself to a frequency that would be different than if it was continuous. Visits may be weekly, monthly, by trimester, or even coinciding with prenatal visit scheduling (monthly until 28 weeks gestation, then every 2 weeks until 36 weeks gestation, then weekly for 3-4 visits). Whichever pattern of scheduling is chosen, remember your resources and feasibility of the schedule chosen. Don’t forget about personnel taking vacations.

Next, think about the day and time of the visit. Was there a day and time that seemed to work well from your focus group? What day and time will work best for your key personnel? If the group visit is conducted outside of the work day, will you be paying your personnel overtime or expecting this to be voluntary? Will your meeting location always be free on the day and time you have chosen?

In our model, our focus group felt that any day of the week would be okay and that early evening time would be best because of work, children and home responsibilities. We next asked the OB group healthcare team their preference for day and time. All agreed that Mondays and Fridays would not be ideal and that 4:30 to 5:30 would be okay as well. We chose Tuesday evenings as a consensus of our OB group healthcare team and decided to conduct the program at a monthly frequency. We chose the third Tuesday of the month mainly because it never coincided with major holidays that would close our clinic. It is easy then for patients and clinic staff to remember – always the third Tuesday of month.

Deciding on the OB group visit topics

Again, if the decision is to have a cohort of similar due date participants or a finite series, it may be best that the chosen topics are either in prenatal time sensitive order or have content that builds on the previous visit. If the decision is for a random due date participant pool, topics may also be random.

In our model, the original topics we discussed were generated from our focus group and evolved as we polled our group participants every few months on topics they would like to hear about. Currently, the topics are “loosely set” – we have a calendar of set topics but may deviate from that depending on who is available to present, a request of topic from the group or if a medical topic emerges that is pertinent to the group such as the Zika virus.