ppratt
MI - Michigan Centering Consortium
Posts: 39
I work at a: Healthcare Facility
My job role is: Staff
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Post by ppratt on Apr 8, 2016 8:15:29 GMT -5
We've noticed that we are having quite a few no shows for Centering lately. We are thinking about using an incentive "program" to increase the show rate. Not sure how we would like to do it at this point. Are there a lot of practices that use incentives to help with attendance/no show rate for groups? If there are, how do you work it and what are your incentives? Do you get donations for the incentives, especially if there are bigger items or do you purchase them from your budget?
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Post by John Craine on Apr 8, 2016 11:03:42 GMT -5
I think it's important to understand why your patients are missing their group sessions. Do you have a robust and reliable system in place to remind patients of their upcoming visits and to followup with them when they don't show up? Are your facilitators adhering to the Essential Elements? Sometimes patient dropout is a sign that the groups aren't all that much fun or informative for the patients. In this case, refresher training may be the answer. If your patients are missing groups due to scheduling conflicts (school, work, etc.) then perhaps holding groups at times more convenient for the patients is the answer.
Regarding incentives, I have heard of practices that will have a basket of baby goodies that they raffle off to patients that have attended a certain number of sessions. In that vein, South Carolina data is showing that patients who attend at least 5 sessions show about 50% reduced risk of preterm birth.
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amelchior
IN - Indiana Centering Consortium
Posts: 23 
I work at a: Healthcare Facility
My job role is: Administrator
I am interested in Centering because: it has the potential to improve the lives of people in our community and is a fulfilling experience for healthcare providers!
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Post by amelchior on Apr 11, 2016 14:15:20 GMT -5
We have also considered doing incentives for our groups. We have a program here called B.A.B.E (Beds and Britches, etc) where patients are given coupons for prenatal care and well child visits that they can cash in at B.A.B.E stores for baby supplies. In Centering patients get them for every visit, which ends up getting them more coupons than in traditional care, but only by a couple more. We also try to work with other community programs, for example we have a safe sleep program where if they attend a session on safe sleep for infants they receive a voucher for a pack and play. We invite the Safe Sleep educator out to our infant safety section and she provides the participants with a voucher. Also, in the past one of our facilitators got a grant to provide incentives for father involvement and getting support people to attend sessions with the moms.
We have had to educate some of our patients that Centering is their prenatal care appointment several times. They will come to Centering then ask when their prenatal care visit is or if they miss Centering, they think they have missed a class and not a doctor's appointment when I call. We have been working on stressing that their group visit is their prenatal care.
We are considering more incentives not only to help with attendance, but thought it might be able to help us recruit more participants. Right now we are exploring getting donations for the items, but if we are able to get enhanced reimbursement from Medicaid we would probably include them in the budget.
I like the idea of doing a gift basket that is raffled off to someone who attended at least 5 visits.
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Post by ColleenSenterfitt on Apr 22, 2016 7:29:41 GMT -5
While recruitment seems to be one of the continuing challenges for many sites, it is more common to hear that attendance is increased in Centering compared to individual care, so it might be helpful to do a complete evaluation of the patient experience. Pull together your steering committee and facilitators to discuss this.
Some questions to ask: Is the group space inviting and comfortable? Do groups start on time and end on time? Is the assessment time organized and time limited? Are openings and closing exercises used? Is there good facilitation to engage participants in the conversation?
An independent focus group (led by someone who is not one of the group facilitators) with some current/ former Centering patients might be helpful.
We would love to hear from any practices who have found good strategies for this!
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paula
New Member
Posts: 2
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Post by paula on Apr 22, 2016 16:44:37 GMT -5
We don't have problems with a no show rate. We make sure they know that they know it is their prenatal appointment and if they cant make it that they need to replace it with a regular individual appointment. We make sure everyone has fun so they want to come back. We tell them first session that session 3 with stress management will be spa day...For labor they know we have the empathy belly. Groups love to share and have fun and don't like it if its didactic or too many movies or speakers. We are always building the next session up and how much fun they will have. Our groups enjoy competitions ie splitting off into 2 groups and seeing which group can come up with the most discomforts of pregnancy and joys of pregnancy. We have some incentives but have found over time we really don't need to use them.  |
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joannastark
New Member
Centering provider since 2013 and the physician lead at an HMO in California
Posts: 2
I work at a: Healthcare Facility
My job role is: Healthcare Provider
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Post by joannastark on Jun 2, 2016 19:38:46 GMT -5
I work at Kaiser in California. In our first year, we had a drop out rate of 25-35%. As a group we realized that the way we were leading Session 1 was a little awkward and not as interesting as we hoped. In addition, people were feeling intimidated by the group-share in front of a very large group, which was up to 26 people including the partners and facilitators. With the changes we made below our retention rate jumped to 90-95%. Interestingly, many fewer couples leave because "the schedule was inconvenient" now and we didn't change the schedule! Of course, it helps that our facilitators are gaining experience, but we have seen awesome retention rates even among newly trained facilitators.
These are the changes we made:
1) Introduction Dyad - we encourage pregnant women to pair up with another pregnant woman and a partner to pair up with another partner. This eases people into the first group activity because they automatically have something in common with the person they are meeting. We noticed a palpable decrease in "awkward energy" with this change.
2) We break the groups down in to 3-4 smaller groups to brainstorm a) what topics they want to cover in Centering and b) the group rules, which we call Group Guidelines. It is great to see what couples want to learn about. We post both the Group Guidelines and the list of expectations at each Session and check them off as we cover those topics. Interesting topic ideas have surfaced such as preparing pets for a new baby, and ergonomics in Pregnancy. It basically serves as a master Parking lot that we can refer back to later.
3) Instead of discussing nutrition at session 1, we cover Common Pregnancy Complaints with the fun game from the Centering Provider Binder. And then cover nutrition in session 2, when women's appetites have improved.
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Post by Tanya Munroe on Jun 7, 2016 14:15:45 GMT -5
Thank you Joanna, what terrific suggestions! Isn't it incredible how a few tweaks to session content can change things so dramatically? Especially at session 1 - we only get one chance to make a first impression  |
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Post by pdublin on Jun 7, 2016 15:58:08 GMT -5
I really like how you've improved Session 1. At a recent site visit, the site was struggling with the same issue. I will definitely share what you've learned! And thanks for sharing this.
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annedenucci
New Member
Posts: 14
I work at a: Healthcare Facility
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Post by annedenucci on Jun 8, 2016 12:44:54 GMT -5
Great discussion! I know that all of our sites are unique and our patients are unique. I definitely see the value and importance of a GREAT first group - organized, getting people engaged, fun, etc. At my site, the no-show rate for Centering is lower than no-show rates for individual appts. Co-facilitators will make reminder/check-in calls for more our more vulnerable pts.
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ppratt
MI - Michigan Centering Consortium
Posts: 39
I work at a: Healthcare Facility
My job role is: Staff
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Post by ppratt on Jun 9, 2016 12:19:07 GMT -5
What kind of time frame do you give the co-facilitator to do the check in call with a patient prior to Centering? Is it a week before, day, etc? Are they blocked time or do they have to work it into their patient flow that day? |
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annedenucci
New Member
Posts: 14
I work at a: Healthcare Facility
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Post by annedenucci on Jun 14, 2016 8:20:44 GMT -5
Co-facilitators have one half day per week dedicated to Centering planning/phone calls/closing charts etc. This works well.
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Post by Tanya Munroe on Sept 22, 2016 15:09:07 GMT -5
In the spirit of making session #1 more fun, one of our sites in Wisconsin has found that having a well-stocked "craft table" for making name tags at session #1 has been a big hit. Moms can't help but have fun while working with glue and flair as they make their decorative name tags that are an extension of their personality and easy talking point : )
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Chelsey Caley
MI - Michigan Centering Consortium
Posts: 12
I work at a: Healthcare Facility
My job role is: Staff
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Post by Chelsey Caley on Feb 17, 2017 9:29:13 GMT -5
In the spirit of making session #1 more fun, one of our sites in Wisconsin has found that having a well-stocked "craft table" for making name tags at session #1 has been a big hit. Moms can't help but have fun while working with glue and flair as they make their decorative name tags that are an extension of their personality and easy talking point : ) oooh would love to see some examples! |
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amydonaldson63
WA - Washington Centering Consortium
#BOOM SITE VISIT APPROVED - Thank you Centering Healthcare
Posts: 83
I work at a: Healthcare Facility
My job role is: Healthcare Provider
I am interested in Centering because: I want to make a difference in someones life for the better and help educate them about the better way of healthcare. I am passionate about what I do with our Centering Program at Kaiser Permanente. I love the lifelong friendships that I build while going thru the journey of pregnancy for all of my patients. I love the personal care that patients receive and I love to keep our groups fun and current. Coming up on being accredited for a year in Jan 2018 and we have grown so much. Already starting 2 groups a month starting Dec 2017, beat our goal to start 2 by a month. #MicDrop
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Post by amydonaldson63 on Mar 3, 2017 1:36:46 GMT -5
Thank you Joanna, what terrific suggestions! Isn't it incredible how a few tweaks to session content can change things so dramatically? Especially at session 1 - we only get one chance to make a first impression |
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amydonaldson63
WA - Washington Centering Consortium
#BOOM SITE VISIT APPROVED - Thank you Centering Healthcare
Posts: 83
I work at a: Healthcare Facility
My job role is: Healthcare Provider
I am interested in Centering because: I want to make a difference in someones life for the better and help educate them about the better way of healthcare. I am passionate about what I do with our Centering Program at Kaiser Permanente. I love the lifelong friendships that I build while going thru the journey of pregnancy for all of my patients. I love the personal care that patients receive and I love to keep our groups fun and current. Coming up on being accredited for a year in Jan 2018 and we have grown so much. Already starting 2 groups a month starting Dec 2017, beat our goal to start 2 by a month. #MicDrop
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Post by amydonaldson63 on Mar 3, 2017 2:02:02 GMT -5
I totally agree with Tanya about the whole first impression thing, I also don't want to overwhelm my new parents at session 1 with a ton of paperwork and showing them how to work the bp machine and getting them to sign photo release and HIPPA sheet in the book, being the Centering Coordinator, I sat back to observe what the other co-facilitators do for their first session, how they prep what do they bring ect, and I addressed my concerns with the Lead Midwife that a couple of the co-facilitators bringing overwhelming amounts of info, forms, ect for the patients for their first Centering session, and some of this info is outdated and should not be handed out. She agreed and told one of them to not bother with all of those papers, just until I can update these forms or find nicer ones, The first 3 sessions in my opinion are crucial because if we overwhelm the patients with tedious stuff like outdated forms, or have a million things to do, 2 things will happen, our numbers will drop because of patients opting out and negative discussion between patients or other ppl in the community that could be on the fence about trying Centering out cause it could be something fun, would probably change their mind and not attend. That is not an option in my mind , we need to do it all the same and we need to be the best we can be and take pride that we can say we are the first in our organization to be accredited. Communication, consistency and calm is what patients need, if we are stressed or running around they will feed off that and then the midwife may feed off that and that is not the Centering concept, so before Centering I have a newer MA, recently graduated college and before she starts Centering, I look at her and tell her to slow down, and breathe and reiterate that she needs to be this way because the patients can feel it and can feed off it and we can't have that. I always want to strive to be the best and give the best care. I want patients walking away going WOW, that was the coolest thing I have ever experienced. The first session , while belly checks are going on and patients are getting snacks and finishing up their vitals and stuff, I don't start the group without my midwife of course but I sit in the circle with the group BEFORE group starts and make small talk, ask them how far was their commute, if they had any questions and I just try and get to know them on a more personal level instead of just professional. I am Amy, I am there for them and I am going to go thru this journey with them. From start to finish, they know they can trust me and count on me, and we develop this bond that is unbelievable. I also have a ton of decorating supplies, stamps, stickers, glitter , markers ect for pts to make their name tags fun, they have a blast.
When you have fun and make it fun, ur numbers increase and patient satisfaction can only go one way..... UP!
I love my job and I love what I do, I love my patients.
~Amy Donaldson CMA
Centering Lead Coordinator
Grouphealth/ Kaiser Permanente Washington
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