Preventing Low Birthweight Infants Through Effective Clinical Collaboration Salt Lake Valley Health

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Preventing Low Birthweight Infants Through
Effective Clinical CollaborationSalt Lake
Valley Health Department

• Audrey Stevenson PhD Iliana MacDonald MPA

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• This session will detail best practices that have
  been achieved through collaboration and aligning
  resources to at-risk individuals in the
  population. The result has been healthier
  outcomes for both mothers and babies in our
  community.

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Objectives

• State strategies to reduce the number of Low
  Birthweight (LBW) Infants born to women receiving
  services through the Clinical Collaboration at
  the SLVHD compared to State and County LBW
  percentages
• List the collaborations and partnerships used to
  reduce LBW infants born in Salt Lake County

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Low Birthweight (LBW) Defined

• LBW defined as an infant weighing less than 2500
  grams or 5 ½ pounds at birth
• Healthy People 2010 goal is for LBW births to be
  reduced to no more than 5 of live births

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Public Health Implications

• We know that the annual societal costs associated
  with low birthweight infants are staggering.
  Through the use of this collaboration, we have
  been able to reduce the number of low birthweight
  infants and prevent the human and societal impact
  the LBW infants can cause.

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Societal Costs

• Healthcare costs are six times higher and the
  length of hospital stay is higher for LBW infants
  weighing between 1,500 and 2,499 grams
• Healthcare costs are 85 times higher for newborns
  born weighing less than 1,500 grams
• Annual societal cost (medical, educational, and
  lost productivity) associated with preterm birth
  was at least 26.2 billion

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Public Health Implications

• Utah has 52,000 births per year
• Approximately half of Utah births occur in Salt
  Lake County.
• The 2006 statewide percentage of low birthweight
  (LBW) infants born in Utah was 6.9.
• The Salt Lake County LBW percentage was 7.4.
• The LBW percentage for the participants of the SM
  collaboration (6.2) is lower than either the
  state or county percentages. (pgt0.5)

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LBW Percentages 2006
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Low Birthweight Infants

• Having a program that has a lower birthweight
  percentage than either the Statewide or County
  percentages has been a significant
  accomplishment. Particularly when one considers
  that the South Main Clinic provides services to
  an at-risk population.

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Utah Birth Rate

• During a 12-month period in 2005 and 2006, Utah
  saw 83.2 births per 1,000 women of child-bearing
  age, compared with the national average of just
  54.9 births per 1,000 women.
• Salt Lake Tribune August 19, 2008

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The Collaboration

• The SLVHD-University Consortium Collaboration
  provides prenatal services at two clinical sites
  in Salt Lake County. This clinic has served as a
  safety net to provide prenatal services to teens,
  women without other access to healthcare,
  high-risk pregnant women and their children.

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Collaborations

• SLVHD
• University of Utah College of Medicine
• University of Utah College of Nursing

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Clinical Sites

• South Main
• Public Health Center
• Ellis R. Shipp
• Public Health Center

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Programs Provided

• Antepartum and postpartum
• Teen Mother and Child Program
• High Risk Prenatal Clinic
• Substance Abuse Project for Women
• WIC

• Immunizations
• Oral Health Program
• Pediatrics
• Promotoras
• Medicaid Eligibility Workers
• Nurse Home Visitation Programs
• On-site Ultrasound
• Non-stress Testing

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Why the Practice is Innovative

• This model is unique by providing integrated
  prenatal services in a community setting with
  surrounding public health services resulting in a
  rate of low birthweight infants lower than either
  the State or County rates.

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Addressing the Issue

• The Salt Lake Valley Health Department partnered
  with the U of U Department of Medicine to provide
  prenatal care to under-served women in Salt Lake
  County.

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The Collaboration

• One goal of this collaboration is to provide
  comprehensive antepartum care with surrounding
  public health services at the South Main Clinic.
• The result has been a level of antepartum service
  that exceeds the care possible by either agency
  outside of this collaboration.

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Barriers

• The success of this project is the sharing of
  resources between multiple agencies.
• The equal engagement of all partners has enabled
  this practice to expand to include high risk
  pregnancies, pregnant women with substance abuse
  problems, and teens.

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Partnerships with other Agencies

• Grants have been awarded to various partners to
  help defray the cost of some services such as the
  provision of an on-site ultrasound and
  sonographer, dental cleanings for women between
  22-26 weeks gestation and a nurse home visitation
  program for all newborns and an intensive nurse
  home visitation program for first time mothers.

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Importance of Partnerships

• With increasing costs and dwindling resources the
  continued support between stakeholders is vital
  to the success and sustainability of this
  practice.

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Conclusion

• The SM Clinical Collaboration has successful at
  reducing the number of LBW infants to a
  percentage that is lower than either the State or
  County percentages
• This program has been successful because of the
  strength and commitment of the partnerships

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