Improving maternal care for new moms in the Hispanic community

Penn Medicine’s Chester County Hospital’s latest patient care initiative focuses on improving postpartum outcomes and decreasing health care disparities.

The Maternal Child Health team at Penn Medicine Chester County Hospital (CCH) was evaluating postpartum complication rates from July 2020 through June 2021, and they noticed an increased rate in complications, such as postpartum hemorrhage and postpartum infection, with Hispanic patients compared to the non-Hispanic population. Since approximately 20 percent of the patients in Maternity identify as Hispanic, the team knew that this patient population needed an extra focus.

Katherine Costantini, Melissa Welsh, and Jennifer Cohen.
From left to right: Katherine Costantini, Melissa Welsh, and Jennifer Cohen, specialists who spearheaded the maternal care initiative. (Image: Courtesy of Penn Medicine News)

For the last several years, multiple teams across Penn Medicine have been working together to improve maternal health outcomes and reduce racial and ethnic disparities system-wide. The United States has the highest maternal mortality rate of any developed country, and maternal health outcomes are even worse for racial and ethnic minorities. Considering the large Hispanic population in Chester County, the need to address disparities for a local community was clear to the CCH team.

“The clinical team felt that there was a gap in how we were providing care, so we went to the data to see if that held true,” says Katie Costantini, co-lead on this initiative.

The team brainstormed ideas and leveraged data to see what could be causing this uptick, and discovered that language barriers, access to care, overall culture, and possible biases were all overarching contributors to the increase in postpartum complication rates.

The primary goal of the initiative is improving postpartum outcomes and addressing health care disparities in CCH Hispanic patients. The secondary goal, which is critical to the long-term success of this initiative, is to build trust with the Hispanic population.

“From my perspective, when you’re doing health equity work, you really need to meet patients where they are. So that was the main push for us, to meet the patients out in the community and on a more personal level in the hospital,” says Costantini.

Building trust with a community is no small task, so the Maternal Child Health team partnered with the Patient Family and Advisory Council (PFAC) to obtain the “voice of the patient” through hospital and community-based interviews.

Having data that reflected the voice of their patients, the team was able to make the needed changes to improve care for Hispanic mothers. With these survey results, the team made changes to improve patient care, including expanding weekday in-person Spanish interpreter services, initiating weekend hours, and creating an “on-call” position for interpreters.

With these solutions in place, the Maternal Child Health team noted that within the last two years, the postpartum complication rates among Hispanic patients at CCH have decreased from 4.9 percent to 2.0 percent. In October 2023, this initiative was recognized by The Health Care Improvement Foundation and the Maternal Child Health team won second place in the 2023 Excellence in Health Care Awards.

This story is by Christina Smith. Read more at Penn Medicine News.