Introducing Flo to patients:
The task of introducing Flo was very much a team effort and to support the service, bespoke patient leaflets were developed with input from the whole service.
Ladies were identified and consented for Flo opportunistically via three routes, the first being
Community Midwives who consented mums-to-be on to the antenatal pathway from 28 weeks onwards, secondly,
post delivery the Maternity Infant Feeding Assistants (MIFA) discussed and consented new mums on hospital wards. Both teams received training around the initial discussion to introduce Flo to patients, as well as patient consent. Once the training was completed, the team were able to complete consent forms with mums across the community and wards, these were then passed on to the dedicated Flo administrator who would create a Flo record and enrol patients on to an appropriate pathway.
Lastly, mums were introduced to Flo via the
antenatal clinic at the local hospital with a joint approach between midwives and the Flo administrator. Midwives would lead the initial discussion in clinic, and then refer mums to a separate clinic area where the Flo administrator would take them through what to expect and to complete their consent form before finally enrolling them into the service. Often mums attending the antenatal clinics would opt in at this stage if they had their mobile phone with them. By utilising the Flo administrator for this initial face to face appointment, the team were able to provide a very personalised service antenatally whilst saving time in their clinical appointments.
Challenges:
After local testing within the team it became apparent that some of the testers with android handsets had been receiving automated notifications from the mobile network provider to warn against possible charges for messaging.
Flo is a free service for patients to use in the UK. However with shortcode numbers often being used for promotional activities at premium rates, some providers inappropriately send out blanket notifications to their customers wherever any shortcode number is used, even in the case of Flo’s free to text shortcode. The team identified this as a potential barrier to mums using the service, and to overcome this they incorporated guidance into their patient information leaflet to provide assurance that all interactions with Flo are free to patients in the UK. They also ensured that the midwives and MIFA’s were made aware of the incorrect network shortcode notices so that it became part of the discussion with the patient during their initial contact.
Specifically for antenatal enrolment, the question of how the team would identify when a mum delivered needed to be addressed. To tackle this, the team were able to use Flo to their advantage by creating a message within the antenatal pathway asking mum’s to share their baby’s birthday with Flo.
Flo then notified the Flo Administrator who could then easily assign the appropriate postnatal pathway to the patient.
The team created a variety of different postnatal pathways to support this approach, ensuring that mums were able to be assigned to an appropriate postnatal pathway for up to 5 days after giving birth. Each pathway ensured that mums received educational messages which were relevant to the age of their new born baby.
Early in their journey with Flo, the administrator was only able to enrol patients from her desktop PC, which on some occasions resulted in mums who had consented to Flo experiencing a few days delay in receiving their opt in message.
This meant they were potentially missing out on some of the valuable early education and information about changes in their babies within their first few days. To better support mums and to ensure they could be enrolled onto Flo as soon as possible, the team purchased a wi-fi enabled tablet which allowed the Flo administrator to have mobile access to Flo to enrol mums more quickly, and often within the clinic at the time of their initial contact.