STRATEGIC QUESTION 1
How can the community expand the concept of cultural competence to ensure access and use of services, including early prenatal care and health screenings?
IMPLEMENTATION PLAN
Chester County Hospital will investigate and understand the specific cultural, community and health barriers to accessing prenatal care in the Hispanic and African American communities.
Prenatal Care Within Easy Reach of Those Who Need It Most
Healthy pregnancies lead to healthier mothers and babies. Receiving appropriate medical care is essential throughout pregnancy, from the earliest weeks of a pregnancy through delivery and following the baby's birth. Unfortunately, for some expectant mothers, acquiring appropriate, comprehensive prenatal care can seem beyond their reach.
In 2013, Chester County Hospital leaders participated in an inclusive community health needs assessment that determined that a significant portion of pregnant Hispanic and African American women right here in our own community were seeking prenatal care far later in their pregnancies than is recommended or safe. Many lived in the Coatesville area, where access to local prenatal care was limited.
Chester County Hospital joined forces with ChesPenn Health Services, a health center in the heart of the City of Coatesville, to bring complete prenatal services directly to the area. According to Mike Lucas, ChesPenn CEO/President, the health organization has provided primary medical care for people of all ages for close to 10 years. However, appointments with the center's obstetrician, Dr. Christine Lyons, were only available one day a week. The center's prenatal care program has now expanded from one to five days each week with the addition of a full-time Chester County Hospital Ob/Gyn nurse practitioner, as well as an RN and other support staff.
"Our relationship with Chester County Hospital has made it possible for us to grow our prenatal services and bring integrated, seamless care to pregnant women in the Coatesville area," says Lucas. "A pregnant woman can now receive top quality prenatal medical attention at a convenient location in Coatesville throughout the majority of her pregnancy. Toward the end of her pregnancy, the mom will choose the hospital she wants to deliver and then transition to the weekly care of an obstetrician or to the hospital's Prenatal Clinic."
"We are able to match the same high level of prenatal care women receive from Chester County Hospital physicians with a far less need to travel," explains Hayley Davis, CRNP, the nurse practitioner who manages the ChesPenn Health Prenatal Care program. Davis' collaborating physician is Dr. Eduardo Mercurio of Penn Ob/Gyn, with whom she keeps up to date on her patients' progress. "Because I work closely with Dr. Mercurio and key hospital staff members, women with low-risk pregnancies can remain in our care for as long as 36 weeks into their pregnancies. If they are identified as high risk at any time, we can transfer them immediately to a physician's group or to Chester County Hospital's Prenatal Clinic."
ChesPenn's expanded prenatal program, which began welcoming patients in May 2014, provides care primarily to the uninsured and underinsured. Because of its association with Chester County Hospital, patients are often eligible for other health care assistance through the hospital. For now, the service itself is funded in large part by an 18-month expansion grant awarded to ChesPenn by the Pennsylvania Department of Health to improve access to this service.
"We are optimistic that we will be able to continue the service after the grant ends. Demand has been strong and we are pleased with the program's growth. In fact, the number of women we have been able to provide with prenatal services in just the first seven months since expanding the program is greater than for the entire previous year," Lucas explains. "We hope to bring the prenatal program to a point where it is covering costs or close to covering costs for the services we provide. Of course, we will continue to look for support from other sources."
Undoubtedly, the services pregnant Coatesville-area women are now able to receive in their own neighborhood will have a significant impact on the lives of many mothers, babies and entire families.
Not only do Hayley Davis and the team watch over a mother's health as well as the health and development of her unborn baby, they reach out beyond what might be expected as routine prenatal care.
"The care we provide here is personalized. A lot of the women who come to us are facing challenges like language barriers, financial struggles or a lack of awareness about the need for prenatal care. A lot of them are overwhelmed, discouraged or even afraid," explains Davis. "They need help understanding pregnancy and childbirth. They need help navigating the health system. They need help finding transportation services in the community. We are here to assist them. We will do whatever we can for our patients and their families."
The prenatal program is just one element of ChesPenn's spectrum of services. Before a woman gives birth to her baby, she is introduced to the clinic's pediatric program and the important role medical attention will play throughout her child's life. Following delivery, care for both mother and infant will continue to the mother's postpartum visit and beyond. The baby can easily transition to the care of a ChesPenn pediatrician.
"Along with watching the mother's health and the development of her baby during pregnancy, we want to make sure the child continues to receive medical care in the future," says Davis. "And we try to encourage all members of a family to follow healthy habits and get proper medical attention. We hope our scope of care is far reaching and will help impact the health of the community."
ChesPenn recently added a new service of benefit to people of all ages, including pregnant women.
"We just merged with a local dental health organization, which means we now provide primary care, dental health care and prenatal care," explains Lucas. "The programs will become integrated so we can be assured that pregnant women are also receiving dental care and primary care. Although we are not quite at the point where we provide one-stop shopping, offering these three programs certainly allows us to provide comprehensive care for pregnant women and others."
Chester County Hospital's relationship with ChesPenn is an example of the hospital's strong commitment to meeting the needs of the underserved in the community. The program is one of many programs developed by the hospital to improve the quality of life for those in need.
Written by Beth Eburn
Photography by Peggy Peterson