Streamlining the Pregnancy Care Management Referral Intake Process

This quality improvement (QI) initiative examined the methods of processing and disseminating Pregnancy Care Management (OBCM) referrals to the OBCM staff. OBCM is a statewide initiative that provides care management services to pregnant women in each North Carolina county. One of the goals of OBCM is to contact the pregnant women within 7 days of the referral being completed. The team leading the QI initiative did not have a defined process for how the referrals were managed once they were received in the office; therefore, the care managers might receive them on the same day or days later. The delay in processing the referrals shortened the amount of time that the care manager had to contact the pregnant women, which made OBCM noncompliant with the set goal.

A team was formed to examine the current methods. This team completed a value stream map (VSM) of the current process. They found that everyone handled the referrals differently, that several staff members handled the referrals, referrals were not being distributed evenly among care managers, and that the process took a long time. 

The team began defining the step-by-step process using the VSM, cutting out wasted steps, tracking the number of referrals given to each care manager, and completing cycle times of the referrals being processed. After the team completed the VSM and saw all of the inconsistencies in how staff handled the referrals and how the referral form went back and forth among staff and would sit on desks for days, they created the step-by-step method of how to process an OBCM referral. At the end of the project, the team had a defined method of how to cut out unnecessary steps, decrease the number of staff members who processed and handled referrals, and decrease the amount of time to get the referrals to the care manager.