Skovholt C, Lia-Hoagberg B, Mullett S, Siiteri R K, Vanman R, Josten L, McKay C, Oberg C N
University of San Francisco, CA.
Public Health Rep. 1994 Nov-Dec;109(6):774-81.
The Minnesota Prenatal Care Coordination Project was a statewide effort to present systematically education and technical support to providers as they implemented the Minnesota Prenatal Care Initiative for expanded services to high-risk women. Educational methods included holding 12 regional workshops throughout the State, one-to-one contacts by nurse consultants, and newsletters and a guidebook (manual) were distributed to reach community providers. Analysis of the implementation was conducted using site visits, interviews with providers, and reviews of medical records, claims data, and other project documents. Successes in the first year were a twofold increase in the numbers of Medicaid-enrolled women who received risk assessment and enhanced services, more than one-third increase in provider participation, greater collaboration among multidisciplinary providers at the community level, and improved communication between State and local health care agencies. Obstacles included provider resistance to changes in practice, dissatisfaction with the enhanced services package and level of reimbursement, and problems with implementation protocols. The project demonstrated that prenatal care providers will change; they will improve practices and collaboration as a result of personalized education and support.
明尼苏达产前护理协调项目是一项全州范围的工作，旨在在提供者实施明尼苏达产前护理倡议以向高危妇女提供扩展服务时，系统地向他们提供教育和技术支持。教育方法包括在全州举办12次区域研讨会、护士顾问进行一对一联系，并分发时事通讯和一本指南（手册）以覆盖社区提供者。通过实地考察、与提供者访谈以及对病历、理赔数据和其他项目文件的审查来对实施情况进行分析。第一年的成果包括接受风险评估和强化服务的医疗补助登记妇女数量增加了两倍，提供者参与度提高了三分之一以上，社区层面多学科提供者之间的合作更加紧密，以及州和地方医疗保健机构之间的沟通得到改善。障碍包括提供者对实践变革的抵触、对强化服务包和报销水平的不满以及实施协议方面的问题。该项目表明产前护理提供者将会改变；由于个性化教育和支持，他们将改进实践和合作。
