New Program at Women & Infants Hospital Aims to Reduce Postpartum Hypertension and Hospital Readmissions

(Providence, RI) – Women & Infants Hospital recently announced a new program that aims to reduce maternal morbidity and hospital readmissions related to postpartum hypertension. The new remote blood pressure monitoring program is offered as a new standard of care to all patients who deliver at Women & Infants Hospital and have a diagnosis prior to hospital discharge of chronic or postpartum hypertension, preeclampsia, HELLP, or eclampsia.

“We are optimistic that this program will reduce maternal morbidity and hospital readmissions related to postpartum hypertension overall and improve health equity among our patients with hypertension,” said Methodius G. Tuuli, MD, MPH, MBA, Chief of Obstetrics and Gynecology, Women & Infants Hospital; Executive Chief of Obstetrics and Gynecology, Care New England Health System. 

All eligible postpartum people are approached by a hospital-employed Nurse Practioner, Danielle Simmons, and bilingual Community Health Educator, Maria Mejia Castillo, to explain the program, provide blood pressure monitors, and educate patients on how to take their blood pressure at home. Patients are then asked to take their blood pressure daily from discharge until 6 weeks postpartum and to upload their results. The Nurse Practioner monitors the results and initiates or adjusts medication as needed. 

Since its launch in November, over 240 patients have enrolled in the Hypertension Equity program and it is already seeing positive results according to Adam Lewkowitz, MD, a member of the Division of Maternal-Fetal Medicine at Women & Infants Hospital. He says, “We estimate that we have successfully kept nearly 40 patients out of our postpartum clinics or Emergency Department by starting or increasing their blood pressure medications remotely when their home blood pressure values were a little too high.” 

The Hypertension Equity Program was created with a multidisciplinary team using a health-equity-centered approach. Black and Latinx patients are at higher risk of having high blood pressure during or after pregnancy and are at a much higher risk of complications from high blood pressure in these periods compared to white patients. So far, nearly 1 in 4 program participants are Black and nearly 1 in 2 patients are Latinx. 
Funding for the cuffs has been covered in a variety of ways. The leadership of Women and Infants Hospital and Care New England made a down payment on the staff and initial stock of blood pressure monitors. United Healthcare and Blue Cross & Blue Shield of Rhode Island supplied their members through a donation, while Neighborhood Health Plan of Rhode Island is offering it as a covered benefit. Some cuffs are also supported by a CVS Foundation/Essential Hospitals Institute grant.

About Women & Infants Hospital
Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation’s leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology, and newborn pediatrics, as well as a number of specialized programs in women’s medicine, Women & Infants is the ninth largest stand-alone obstetrical service in the country and the largest in New England with approximately 8,700 deliveries per year. Women & Infants is a Designated Baby-Friendly® USA hospital, a U.S. News & World Report 2014-15 Best Children’s Hospital in Neonatology, and a 2014 Leapfrog Top Hospital. The Department of Obstetrics and Gynecology ranked number 11 in U.S. News & World Report’s 2019 Best Medical Schools specialty ranking.
Women & Infants has been designated as a Breast Imaging Center of Excellence by the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; Centers of Biomedical Research Excellence in Perinatal Biology and in Reproductive Health by the National Institutes of Health (NIH); and a Neonatal Resource Services Center of Excellence.  It is one of the largest and most prestigious research facilities in high-risk and normal obstetrics, gynecology, and newborn pediatrics in the nation, and is a member of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network, Neonatal Research Network, and Pelvic Floors Disorders Network, as well as the National Cancer Institute’s Gynecologic Oncology Group.