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Healing at Home: applying innovation principles to redesign and optimise postpartum care
  1. Jessica S Gaulton1,
  2. Kirstin Leitner2,
  3. Lauren Hahn3,
  4. Ryan Schumacher3,
  5. Lori Christ4,
  6. Laura Scalise2,
  7. Deborah S Driscoll5,
  8. Roy Rosin3,
  9. Raina M Merchant6
  1. 1Neonatology, Jefferson Health–Abington, Abington, Pennsylvania, USA
  2. 2HUP Obstetrics and Gynecology, Penn Medicine, Philadelphia, Pennsylvania, USA
  3. 3Center for Health Care Innovation, Penn Medicine, Philadelphia, Pennsylvania, USA
  4. 4Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  5. 5Office of the Dean of the University of Pennsylvania, Penn Medicine, Philadelphia, Pennsylvania, USA
  6. 6Emergency Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Jessica S Gaulton, Neonatology, Jefferson Health - Abington, Abington, PA 19001, USA; jessicagaulton{at}gmail.com

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Summary box

What are the new findings?

  • Applying a human-centred, design thinking framework can help clinicians deeply understand the unique human needs of a specific patient population.

  • The Healing at Home pilot data validated the acceptability and desirability of text messaging as a means of communication with new mothers after childbirth.

  • The Healing at Home programme improved continuity of care for postpartum patients through a bundle of services which included expedited discharge paired with a novel texting service, comprehensive lactation support, and in-home nursing.

How might it impact on healthcare in the future?

  • ‘This novel approach to postpartum care developed by the Healing at Home programme proved to be invaluable during the pandemic. Mothers were able to leave the hospital early knowing that they were only a text message away from the support they might need.” (Dr. Deborah Driscoll, Senior Vice President, Penn Medicine)

Introduction

Background

Currently, in the USA, there is a critical gap in care for mothers and their newborns in the first several weeks after childbirth, which is the period with the highest risk of maternal and neonatal morbidity and death. New mothers often lack the necessary support services as they transition from hospital to home after childbirth.1 Traditionally, a single postpartum visit is scheduled 4–6 weeks after delivery, and it is estimated that up to 40% of women do not receive postpartum follow-up care.2 Early follow-up is particularly important for women with a history of gestational hypertension3 to increase breastfeeding adherence rates4 and to screen for symptoms of postpartum depression.5

In 2018, The American College of Obstetricians and Gynaecologists published a committee opinion emphasising the urgent need to redesign the postpartum experience, highlighting that postpartum care should be an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs.6

Our team developed the Healing at Home programme with the goal of redesigning …

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Footnotes

  • Twitter @jessgaulton

  • Contributors JG codeveloped the methodology described in the article, interpreted the resulting data, managed the drafting and revisions of the manuscript, and was responsible for the overall content as guarantor. KL, RS and LH codeveloped the methodology described in the article, managed the data reporting and were initial contributors to the manuscript. LC, LS and DSD supported the evaluation of the methodology and critically revised manuscript drafts. RR and RMM supported the development of the methodology, interpreted the resulting data, encouraged the drafting of the manuscript and critically revised the manuscript drafts.

  • Funding This work was supported by Penn Medicine’s Centre for Healthcare Innovation through the Innovation Accelerator Grant.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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