Perinatal Reproductive Education Planning and Resources (PREPARe)
Last updated
Share PrintPREPARe's mission is to create accessible, in-house, specialized services that provide integrative care, education and support to Veterans and their families on their reproductive journey. Providing services at the VA will allow for specialized Veteran centric care and assist in promoting and maintaining positive health outcomes for pregnant and postpartum Veterans and their families
Origin:
October 2020, Orlando VA Medical Center
Adoptions:
6 in-progress
Awards and Recognition:
2021 Under Secretary for Health’s Robert L. Jesse Award , 2021 VISN 8 Innovation Forum, FedHealth IT Award, 2023 Service to the Citizen Award, 2023 G2X Change Agent Award, 2023 Mod ... 2021 Under Secretary for Health’s Robert L. Jesse Award , 2021 VISN 8 Innovation Forum, FedHealth IT Award, 2023 Service to the Citizen Award, 2023 G2X Change Agent Award, 2023 Modern Healthcare Top 25 Emerging Leaders
Partners:
Diffusion of Excellence, Healthcare Innovation and Learning, Systems Redesign and Improvement, VHA Innovators Network
Recent Updates
Overview
The problem
Approximately 4000 pregnant Veterans access VA maternity benefits annually. Because VA doesn't offer these services in-house, Veterans must seek care from multiple community providers to receive covered perinatal services. Veterans are at a higher risk for perinatal depression, mood, and anxiety disorders, and up to 40% of pregnant Veterans have PTSD which i
...
Approximately 4000 pregnant Veterans access VA maternity benefits annually. Because VA doesn't offer these services in-house, Veterans must seek care from multiple community providers to receive covered perinatal services. Veterans are at a higher risk for perinatal depression, mood, and anxiety disorders, and up to 40% of pregnant Veterans have PTSD which increases risks of pregnancy complications. Having to cobble together sufficient perinatal care from community providers puts an already at-risk population in a position to receive poor continuity of care and variable quality of care, in addition to having to pay for many of these services up-front and navigating a complex system to be reimbursed. Community providers can have high fees (Ex: hypnobirthing courses $300/class) and Veterans need to go back 2-3 times.
These significant time and financial barriers are exacerbated by the decentralized nature of accessing community care. See more
These significant time and financial barriers are exacerbated by the decentralized nature of accessing community care. See more
Images
Above:
Before
Links
- Examining Pre-Pregnancy Health and Maternal Outcomes Examining Pre-Pregnancy Health and Maternal Outcomes among Women Veterans
- Military sexual assault and harassment are linked to higher rates of depression Military Sexual Assault Linked to Depression, Mother-Baby Bonding Problems Among Veterans
- The VA has included pregnancy-related care in its medical benefits package since 1996. Recent estimates indicate that approximately 4,000 veterans use this benefit every year. For all labor and delivery care and nearly all prenatal care, the VA pays for veterans to see providers in their communities. Birth Equity for Veterans and Servicemembers
- Findings show that pregnant Veterans who use VA coverage have elevated rates of trauma exposure and mental health conditions that increase risk for pregnancy complications and adverse maternal and infant outcomes. Women Veterans & Pregnancy Complications
The solution
OVAHCS developed the Perinatal Reproductive Education Planning and Resources (PREPARe) program, a one-stop shop, wraparound approach to perinatal care that reduces hassle of reimbursements, ensures consistent quality of care, and allows Veterans to build relationships with VAMC providers and brings patients back to VAMCs for future pregnancies and other peri
...
OVAHCS developed the Perinatal Reproductive Education Planning and Resources (PREPARe) program, a one-stop shop, wraparound approach to perinatal care that reduces hassle of reimbursements, ensures consistent quality of care, and allows Veterans to build relationships with VAMC providers and brings patients back to VAMCs for future pregnancies and other perinatal related care.
PREPARe improves collaboration between Primary and Maternity providers, and allows trained VA specialists to offer services typically offered in the community. These resources include perinatal yoga, lactation counseling, perinatal certified MH providers for psychotherapy and psychopharmacology, hypnosis and childbirth, nutrition groups, pelvic health physical therapy, and more. See more
PREPARe improves collaboration between Primary and Maternity providers, and allows trained VA specialists to offer services typically offered in the community. These resources include perinatal yoga, lactation counseling, perinatal certified MH providers for psychotherapy and psychopharmacology, hypnosis and childbirth, nutrition groups, pelvic health physical therapy, and more. See more
Images
Above:
PREPARe Brochure
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PREPARe Brochure
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PREPARe Poster
The results
OVAHCS provides a one stop shop for perinatal education and resources.
- Couple who experienced stillbirth of twin boys “We got a lot out of it and have shared some of the information with family members and even though it has been four years since our loss we are learning how to honor our twins and learning how to talk about them with our youngest child ... OVAHCS provides a one stop shop for perinatal education and resources.
- Couple who experienced stillbirth of twin boys “We got a lot out of it and have shared some of the information with family members and even though it has been four years since our loss we are learning how to honor our twins and learning how to talk about them with our youngest child and keeping their legacy alive."
- Veterans stated "I wish PREPARe would have been around for my first child."
-Veteran shared "It's good to be able to rely on the VA for maternity resources. Recognizing we're deserving of just as much support. I was pretty impressed when I got plugged in."
-Veteran shared "Successfully breastfeeding my 8 month old baby thanks to PREPARe."
- VA Providers state " I love being able to support women veterans on their lactation journey, a service not previously offered. Truly grateful to have the support of the Orlando VA as we provide this new service to veterans and their families. It has been refreshing to dispel myths about breastfeeding and provide support on their nursing journey.” See more
- Couple who experienced stillbirth of twin boys “We got a lot out of it and have shared some of the information with family members and even though it has been four years since our loss we are learning how to honor our twins and learning how to talk about them with our youngest child ... OVAHCS provides a one stop shop for perinatal education and resources.
- Couple who experienced stillbirth of twin boys “We got a lot out of it and have shared some of the information with family members and even though it has been four years since our loss we are learning how to honor our twins and learning how to talk about them with our youngest child and keeping their legacy alive."
- Veterans stated "I wish PREPARe would have been around for my first child."
-Veteran shared "It's good to be able to rely on the VA for maternity resources. Recognizing we're deserving of just as much support. I was pretty impressed when I got plugged in."
-Veteran shared "Successfully breastfeeding my 8 month old baby thanks to PREPARe."
- VA Providers state " I love being able to support women veterans on their lactation journey, a service not previously offered. Truly grateful to have the support of the Orlando VA as we provide this new service to veterans and their families. It has been refreshing to dispel myths about breastfeeding and provide support on their nursing journey.” See more
Images
Above:
AAMFT Article
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National Press Relesase
Above:
Ms. Tran selected as a Senior Innovation Fellow for PREPARe
Links
- PREPARe recognized by American Association for Marriage and Family Therapy AAMFT Member Melissa Tran Wins Dr. Robert L. Jesse Award
- Innovation Revolutionary: Melissa Tran is innovating Veteran centric perinatal care Innovation Revolutionary
Metrics
- Consults to PREPARe since Feb 2021: 540+
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Multimedia
Videos
Above:
Melissa Tran Awarded Dr. Robert Jesse Award for InnoVAtion Excellence as presented by Dr. Carolyn Clancy - start video at 29:50
Above:
Diffusion Academy Testimonial: Melissa Tran
Above:
VA Innovation PREPARe
Implementation
Timeline
-
Q1
1. Work with Orlando team to scope pilot / align on which services to include (e.g., recommended “starter-pack”)2. Design program governance and meeting cadence3. Define milestones and KPIs for the pilot, supported by a robust measurement plan4. Secure funding and train providers5. Hire or provide dedicated time for an existing employee to act as program coordinator -
Q2
1. Leverage existing collateral and create new content to publicize available services2. Begin delivering new service3. Review progress against milestones and KPIs4. Align on additional services to provide, train relevant providers5. Continue to build provider awareness of available service6. Collect Veteran feedback -
Q3
1. Roll-out additional services2. Continuously improve provided services based on Veteran feedback and lessons learned3. Review progress against milestones and KPIs4. Work with the Orlando team to collate and share outcomes and cost saving data
Departments
- Maternity
Core Resources
| Resource type | Resource description |
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PROCESSES |
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TOOLS |
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Links
- Overview and Spend Plan PREPARe
Optional Resources
| Resource type | Resource description |
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PEOPLE |
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TOOLS |
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Support Resources
| Resource type | Resource description |
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PEOPLE |
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PROCESSES |
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Risks and mitigations
| Risk | Mitigation |
|---|---|
| Staff Turnover | Support and Empower Staff |
About
Origin story
“I knew I couldn’t be the only one who felt lost navigating my pregnancy and postpartum period, so it became part of my mission to make sure that perinatal services, education, and support are readily available to all across our healthcare system. A collective team of professionals and I share the heart for helping perinatal families feel seen and supported
...
“I knew I couldn’t be the only one who felt lost navigating my pregnancy and postpartum period, so it became part of my mission to make sure that perinatal services, education, and support are readily available to all across our healthcare system. A collective team of professionals and I share the heart for helping perinatal families feel seen and supported during such a precious and vulnerable time. We are here for you.” - Melissa Tran, LMFT
Original team
Melissa Tran, LMFT, PMH-C
Marriage and Family Therapist
Lisa Martel, LCSW
Woman Veterans Program Manager
Jasimine Joiner, LCSW
Woman Veterans Program Social Worker
Glorian Chehade, RN, MPH
Maternity Care Coordinator
Khenitha Reeves, LPN
Whole Health Coach
Kim Bielicki
Innovation Specialist
Comment
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