Supporting Indiana Mothers

Social Finance worked with Goodwill’s Nurse-Family Partnership (Goodwill NFP), a community health program that pairs vulnerable first-time mothers with registered nurses, to analyze its operations and develop a set of recommendations that would enable the program to reach more high-risk mothers and improve program performance.

Goals

• Continue to provide quality care and improve birth outcomes while undergoing program expansion.
• Reduce the attrition of program participants and NFP nurses.
• Understand and leverage operational data to set goals and track progress.

The Work

Social Finance helped Goodwill NFP develop and implement strategies to achieve these goals, including:

• Data analysis: Analyzed Goodwill NFP’s programmatic data collected from 2011 through 2018 to identify the variables most meaningful to operational efficiency and scale: referrals, nurse caseload, and nurse and participant attrition.
  • Determined the top referral sources, concluding that health care providers and the Women, Infants, and Children (WIC) Program had the lowest conversion rates, while referrals collected in-person at human services offices and schools had the highest conversion rates.
  • Determined that the average caseload was 17-20 clients per nurse, with tenured nurses carrying larger caseloads and newer nurses reaching full caseload in around 12 months. Social Finance also noted that nurses’ other responsibilities, including case management, charting, travel, and referral generation, affected their caseloads.
  • Determined that participants who graduated had their schedules adjusted more frequently than those who did not continue with services, and participant attrition was highest during the prenatal period.
• Operational refinement: Recommended and developed multiple program improvements, based on our data analysis, to increase nurse support and optimize scheduling, including:
  • A smartphone application-based time-tracking system to analyze nurse time management and find opportunities for greater efficiency in scheduling to reduce travel time and support serving more participants.
  • A nursing team announcement and communications system using podcasting to reduce the need for in-person meetings and streamline information sharing.
  • An operational monitoring platform centered on data visualization software meant to empower decision-makers and allow for on-the-fly strategic improvements.
• Performance management: Established templates and data tracking tools, including a data dashboard, to monitor progress against operational targets. Social Finance created biweekly, monthly, and quarterly stakeholder meetings, including executive sessions with operations, Goodwill executives, external partners such as the Indiana Department of Health, and the NFP National Service Office.

The Results

• Implemented a performance dashboard that provides real-time updates on key performance indicators to drive performance improvement management, as well as a more outcomes-based culture.
• Catalyzed measurable field improvements, including a two-fold referral traffic increase in Johnson County, Indiana.