Planning, Implementation, and Evaluation of a Postpartum Nurse Home Visit Service to Improve Health Equity

Objective: To describe how a college of nursing and urban academic medical center partnered with the local health department to plan, implement, and evaluate a universal nurse home visit service to improve health equity in the postpartum period. Design: Evidence-based practice. Setting/Local Problem: Wide health disparity in rates of maternal and infant morbidity and mortality in Chicago, Illinois. Patients: All patients who gave birth at the medical center and lived in Chicago. Intervention/Measurements: A nurse home visit was offered after birth to all eligible patients beginning in March 2020. We used data from a Web-based platform to determine key performance indicators for the program and examined patient demographics to determine equitable delivery of the service for all visits provided in 2022. Results: There were 1,488 patients eligible for a home visit and 714 who received a home visit. The average contact rate was 76%, the scheduling rate was 63%, the completion rate for scheduled visits was 76%, and the population reach was 48%. Sixty-eight percent of families visited were from high-economic-hardship zip code areas of the city. Eighty-one percent of visits resulted in at least one referral to meet a family's need, and 98% of patients surveyed rated their visit as "very helpful." Conclusion: The successful implementation of this public-private partnership was due in part to an organizational culture that supports health equity initiatives, the inclusion of system-wide stakeholders, having a process in place to monitor outcomes, and hiring a diverse team of nurses who prioritize respectful patient-centered care.