Orlando Health Program Prevents Readmissions for New Moms

By Alan Schmadtke, Editorial Contributor

New mothers at risk of complications after delivery are receiving extra care and education to help keep them healthy and at home through a program at Orlando Health Winnie Palmer Hospital for Women & Babies.

Launched in 2020, the virtual visit program is designed to help new mothers monitor and manage high blood pressure, which is a primary reason for hospital readmissions.

A team of licensed practical nurses (LPNs) recruits patients after delivery, and the moms receive a blood pressure cuff and are shown how to use it. The nurses also describe warning signs to look for and explain when the patients should see their healthcare provider or seek emergency care.

Going home

More than 75 percent of readmissions for high blood pressure occur in the first week home, so each patient receives two 20-minute telehealth visits, the first on Day 2 and the second on Day 4 or 5.

In addition to reviewing blood pressure logs, symptoms and medications, the nurses inspect C-section incisions and check for signs of postpartum depression, which can prompt more visits to emergency rooms and acute care centers.

The program also includes virtual visits with lactation consultants to help with any nursing problems and social workers who can screen for food insecurity and other issues that can affect the mother’s health.

Important first days

The telehealth program helps bridge the healthcare gap for patients who struggle to get to follow-up appointments because of lack of transportation or childcare.

“Historically, we know adherence to postpartum hypertension visits can be poor, with rates for some populations as low as 30 percent,” says Dr. Lori Boardman, chief quality officer of Orlando Health Winnie Palmer. “Through the telehealth program, care occurred in the home, and nearly 70 percent of patients enrolled in the program have been able to complete at least one visit.”

Another benefit has been a decrease in hospital readmissions, which affects the entire family. Early recognition of worsening hypertension by the LPN team and same-day communication with doctors allows for management in the office setting rather than the hospital.  

“The goal is to allow the family to create those initial bonds,” Dr. Boardman says. “These are particularly important first days for both the baby and the mother.”

The future

New moms who experienced hypertensive disorders during pregnancy also are at increased risk of cardiovascular disease and hypertension in the future.

“Our ultimate goal is to be able to follow this population after pregnancy and provide the clinical care and resources needed for them to remain healthy in the long term,” says Dr. Boardman.

“Pregnancy has been described as a stress test, one that uniquely allows us to get a glimpse of the future for women currently in their reproductive years,” she says. “What we do with that information has the potential to make a difference in their future.”