Designing a Care Pathway for a Maternity Support Service Program in a Rural Health Department


Address correspondence to Shelly Olds, M.S.N., R.N., Nursing Supervisor, Lewis County Health Department, 360 NW North Street, MS:HSDO3, Chehalis, WA 98532.


Abstract Today's heath care system in the United States faces many financial dilemmas related to the country's current economic status. Despite dwindling resources, the health care system must continue to provide high quality care to meet ever-increasing demands (Ferguson, 1993). Care pathways are an example of case management tools which provide care coordination. With an interdisciplinary approach, pathways increase communication and continuity of care between service disciplines, as well as improve efficient resource utilization. The purpose of this paper was to review: (1) the literature related to the benefits of using care pathways to enhance client care: (2) the benefits of public health nurse home visitation to pregnant and postpartum women; and (3) to describe the process to design a care pathway for the Maternity Support Service (MSS) program at a rural health department. This health department provides MSS to a county with a population of 65,000, with over 900 births per year. The county is 100 miles wide and 28 miles long. Thus, the MSS staff cover a large area, and needed a method to maximize efficient use of staff time. Care pathways have tremendous appeal because they accomodate interdisciplinary teams of care, focus on process, reduce unnecessary variation in care, and attend to quality and client outcomes (Pearson, Goulart-Fisher, & Lee, 1995).