Reducing Newborn Office Visits and Improving Satisfaction through Parent Education and Learning Communities
Andrea Rudominer, MD, MPH
Summer 2009 - Volume 13 Number 3
First-time parents have many questions about caring for their newborns, including concerns that are not addressed during the standard follow-up visits two days and two weeks after childbirth.1 These questions often bring the parents into the physician's office, but in many instances these visits are unnecessary and the issue could have been resolved by phone or by e-mail. In my clinical experience, parents are often annoyed when they realize that this is the case; they feel that they have wasted their time and money. At the same time, unnecessary visits increase costs and overburden physicians with visits that do not require their specialized training, leading to job dissatisfaction and burnout. Thus, the Kaiser Permanente (KP) health care system is adversely affected by these unnecessary visits.
Educational programs can empower patients by teaching them when it is necessary to come in for a visit and when they can wait a situation out or try home remedies. Group education is an efficient way to educate patients and parents.2–4 It offers an opportunity for clinicians to reach more than one person at a time while providing parents the chance to learn and feel support from others in a situation similar to their own.5,6
Numerous types of pediatric office visits can be handled by inexpensive patient-education programs or parents sharing knowledge with each other. These include routine questions from new parents, particularly at key child-development milestones, and questions about newborn rashes, breastfeeding, constipation, and upper respiratory infections.
At KP San Jose (formerly Santa Teresa), we conducted a pilot program targeted at parents of newborns to test the hypothesis that education, specifically group education with phone follow-up, could serve to reduce the frequency of unnecessary office visits while simultaneously increasing member satisfaction with KP's newborn care experience.