Improving Maternal and Infant Services in Rural Iowa

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Tom Haederle
As in many areas of the country, maternal health access is a real issue in rural Iowa, where an increasing number of counties have seen reduced services or none at all. St Anthony's Regional Hospital in Carroll, Iowa, has stepped it up to address that gap.

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Tom Haederle
Welcome to Community Cornerstones: Conversations with Rural Hospitals in America, a new series from the American Hospital Association. I'm Tom Haederle with AHA Communications. St Anthony's response to the shrinking access to maternal health care services throughout the six counties it serves in rural Iowa can be described in three words: The Birth Place. This grant-funded Center of Excellence has not only expanded and improved health outcomes for moms and their babies, it has also helped ignite the passion for health care in students and future providers.

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Tom Haederle
Three leaders from The Birth Place sat down with the AHA’s Julia Resnick to discuss the tactics and strategies that are making a difference.

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Julia Resnick
This is Julia Resnick, director of Strategic Initiatives at the American Hospital Association, coming to you from the Rural Health Leadership Conference. I'm here this morning with three outstanding leaders from Saint Anthony Regional Hospital in Carroll, Iowa. We have Allen Anderson, president and chief executive officer, Virginia Uhlenkamp, OB, director at Thr Birth Place, and Ashleigh Wiederin, OB outreach coordinator at The Birth Place. Allen, Virginia,

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Julia Resnick
Ashley, thank you so much for joining me this morning to talk about maternal health. So I know for a lot of our hospitals, maternal health access is a real issue. And that's no different in Iowa, where many of your counties don't have obstetric services. So it's my understanding that you've piloted the Center for Excellence in the last year as the hospital's way of bringing care to infants and moms within your area.

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Julia Resnick
So, Allen, can you talk about the impetus for starting the center and the elements of the the Center of Excellence program?

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Allen Anderson
Sure and thanks for having us. This work was really started prior to the Center of Excellence. We wanted to set a foundation. We had a governance, our governance board that really supported this work. We identified this as an issue because of the access, because of some of the quality initiatives regarding maternal health, OB services. And so really, that foundation was set before the Center of Excellence.

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Allen Anderson
The Center of Excellence really was just something that came after that allowed us some funding to be able to continue the work. So it's really exciting. We see more and more facilities around us get out of doing OB and labor and delivery services. And so it is important work for us to preserve that access for our patients.

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Julia Resnick
So Ashleigh can you tell us about what happens at The Birth Place? What is this program like?

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Ashleigh Wiederin
So for the Center of Excellence, our goals were really centered around increasing that access to care and also implementing things that improve the health outcomes for our moms. So we've been able to expand prenatal appointments to a few of our outreach clinics and then use some of our partnerships to improve those outcomes. Kind of include activities that really enhance that overall patient experience.

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Julia Resnick
That's really wonderful. And now that you've been implementing this program for a few months, can you share some of the learnings or challenges you're experiencing? Ginny, I'll turn to you.

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Virginia Uhlenkamp
Yeah, some of the learnings that we've had is, number one, for me as a nurse to learn about the complexities of health care and kind of looking at that big picture. We've learned a lot about what happens at the legislative level, both in federal and state, and how to bring that focus and goals for maternal health down to the bedside and, you know, to let our nurses know that indeed, our federal and local leaders do care about maternal health and what they do matters.

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Virginia Uhlenkamp
Challenges, of course, we're going to talk about workforce issues. I think it's important to find the right people for the right position or place at the table, and that involves some of our outreach activities. And then to the students to ignite that passion for health care, to encourage and expose those students. You know, there are people out there that have a passion for health care

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Virginia Uhlenkamp
we just have to bring them into the circle and light that fire, I say.

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Julia Resnick
And maternal health is so one of those like, passion issues that, like a lot of people have it in their hearts and like to really want to support moms and babies.

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Virginia Uhlenkamp
Exactly.

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Julia Resnick
That's exciting. So what about the outcomes that you're seeing from this new program? Have you seen any improvements to date? And like, what are the metrics that you're measuring to help, you know, if you're making progress? Ashley I'll turn it to you.

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Ashleigh Wiederin
Sure. So our first year of kind of rolling out the Center of Excellence, the focus there was on relationship building and partnership engagement. We had really great success with that and were able to create documented partnerships. That was something that the grant required as a deliverable, and we were successful in that with partnerships in all six counties in our service area.

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Ashleigh Wiederin
As we moved into the second year, our our focus kind of shift on that patient engagement, like I said, improving those outcomes. And one of the things that we've noticed is a sharp increase in our class attendance. We kind of restructured some of the educational offerings that we had, and more specifically, our participation in our postpartum support group.

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Ashleigh Wiederin
That has really increased not just in the number or the volume, but in the longevity. So moms are coming to group and then they're continuing to show up. That's once a week. And we see moms that are now coming through their entire maternity leave and then they're building a community and caring those relationships when they go to work.

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Ashleigh Wiederin
We hear "we met for dinner" and they'll send us photos of their babies and the moms getting back together. So that's been a really great thing to see. And one of the really positive outcomes that we've noticed.

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Julia Resnick
That's so cool to hear about how you're building community. Absolutely. Love that story. And I just want to congratulate all of you for the work that you're doing. It's really exciting and so important in our rural communities. Before we wrap up, Alan, I want to ask you what's next for this program and for St. Anthony's work in the maternal health space?

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Allen Anderson
The easy answer is we do not know. A lot of this is being reactive to some of those external pressures. So as more and more of those facilities get out, we have the opportunity to grow in this area. So what we've been really focused on is setting that foundation. That foundation will help us realize those growth opportunities as some of those external pressures come to fruition.

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Allen Anderson
So the easy answer again is we don't know, but we're setting our foundation to be able to be successful in the future.

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Julia Resnick
Well, thank you to your commitment to maternal health in the rural setting. I'm sure that your your community really appreciates that. And I want to thank all of you for joining me this morning to talk about this important issue. Thank you so much. Thank you.