In 2011, Sentara Obici Hospital was awarded a two-year grant to identify and implement effective screening and assessment tools to determine the level of community support expectant and new parents needed for both their personal wellness and their child’s development.

Known as the “Newborn and Family Screening and Referral” (NFSR) Pilot Program, Sentara Obici Hospital partnered with the Western Tidewater Health District to provide access to programs and professionals with the knowledge and tools to foster healthy pregnancies and healthy babies.

Gaps in the community resources, both types and capacity of existing referral resources, were identified based on the data provided through the NFSR pilot program.

Funding was provided through Smart Beginnings South Hampton Roads and matched by Obici Healthcare Foundation.

BACKGROUND

Of the 2706 families screened, 4687 referrals were made to many of our community partners including:

150 to Healthy Families 1308 to First Steps 206 to Nurse Family Partnership 135 to other cities for home visiting services

RESULTS Develop a nurse-administered hospital-based

screening tool and process (Maternal Nurse Navigators) to identify families’ needs and potential psychosocial risk factors.

METHODOLOGY

Newborn and Family Screening and Referral Pilot at Sentara Obici Hospital Lori White, RN, Phyllis Stoneburner, BSN, RN, MBA, Hattie Boone, MSN, RN, CMC, Miranda Powell, BSN, RNC-OB, LCCE,

Mary Ann Echols, BSN, RN, Tandy Coyle, RN, Virginia Savage, MSN, RN

PROBLEM

Before the pilot in South Hampton Roads, there was not a single systematic approach to screen, refer and follow all babies and their families.

Sentara Obici Hospital had only screened first time mothers through the Healthy Families Program.

CONCLUSIONS

The pilot enabled all mothers to be screened and referred for services as needed and available based on the unique needs of each family.

4687 referrals were made during the pilot period, many of whom would have previously received no services, especially in the prenatal and multi-gravitis population.

554 families, who were at high risk, fell into the gap for services (57 were in first pregnancies and 497 were in subsequent pregnancies).

This program serves as a roadmap for the important ways that collaborative partnerships and community investment can achieve a healthy future for our youngest and most vulnerable citizens.

The program’s process is highly applicable to replication at other Sentara Hospitals and regional communities.

There is a need to build capacity in existing referral programs and to grow the roster of community resources for parents and children.

The program is also limited for long-term sustainability by a consistent revenue stream.

WHY IT MATTERS In the most recent Community Health Assessment, Sentara Obici Hospital’s service area was identified as having higher than state averages for infant mortality, low birth weights, births without early prenatal care, non-marital births and teen pregnancies.

Provide face-to-face contact to all parents, offering parenting skill-building resources and information at the time of their child’s birth.

Here We Grow Suffolk Along with prenatal checkups, vitamins and childbirth classes, parents can add the website www.HereWeGrowSuffolk.com and social media channels to their toolkit of health and parenting resources. The website provides contact information, community resources, events and links to e-newsletters covering timely topics for moms-to-be and parents.

Collaborate with the Western Tidewater Health

District to reach high-risk, low- income families during pregnancy.

Under the auspices of the Western Tidewater Health District, the Nurse-Family Partnership program was launched. It was the first such partnership in the Commonwealth of Virginia. This nurse-led, evidence-based home visitation program covers early pregnancy until the child turns two years old.

Connect families to services they qualify for

through electronic referral system. Community resources are vital to filling the information gap for families as their child develops.

The “Go Beyond Well Family System” technology and electronic interface between Sentara Obici Hospital and the Western Tidewater Health District allowed seamless communication.