The medical database as a tool for improving maternal/infant continuity of care.

Analysis of the Sinai Health System's integrated medical database revealed a serious discontinuity of care, frequently observed in underserved communities, for mothers who delivered at the hospital but failed to return on a timely basis for postpartum visits for themselves and newborn visits for their babies. Since the Sinai Health System (SHS) is a fully integrated health system including community-based primary care, a process improvement project to improve rates of return was initiated. Prior to hospital discharge, a staff member visited each new mother and baby to schedule clinic follow-up appointments. Appointment compliance was monitored using the SHS integrated medical database. Results after the first year showed marked improvement. Eighty percent of mothers returned for postpartum care within 4 months of delivery compared to 46 at baseline. Eighty eight percent of newborns were seen in the clinics within the four month timeframe compared to a baseline of 59%. The integrated medical database not only allowed for identification of this problem but was an essential tool at each point in the intervention.