Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Dr. Marie VanderKooi, DNP, MSN, RN

Second Advisor

Joann Hoganson, MSN, RN

Third Advisor

Karen Sall, MPA, RN

Fourth Advisor

Dr. Kelli Damstra, DNP, MSN, RN


Introduction: In a Midwest Health Department’s (HD) Maternal Infant Health Program (MIHP), infant death rate has been on a steady incline at 4.8 deaths per 1,000 in 2019 (Michigan Department of Community Health, 2020). Implementation of a “warm handoff” between the local HD and Michigan Department of Health and Human Services (MDHHS) was created to increase enrollment and visits. During warm handoffs, health care providers work together within the same setting to provide evaluation and care to patients and clients (Musselman et al., 2018).

Methods: This program evaluation reviewed data retrospectively from March 31 to September 30, for 2019 and 2020. Data were analyzed using percentage change calculations, Wilcoxon Signed Rank Test, and common themes from a staff survey.

Results: A total of 946 records were reviewed between three groups: 2019, 2020 “warm handoff” pilot program, and 2020 cold calling. Data percentage change calculations showed a 1.3% decrease in enrollment from 2019 to 2020, and 26% less clients enrolled in the pilot program compared to cold calling. Data Percentage Change calculations also resulted in a 24.0% increase in completion of three or more visits from 2019 to 2020, and 23.2% less clients completing three or more visits in the cold calling group compared to enrollment in the pilot program. The Wilcoxon Signed Rank Test resulted in a Z score of -2.20 and a p-value of 0.028. Staff survey responses stated the “warm handoff” was successful in enrolling clients, but not subsequent visits. Barriers were present within the program, including telehealth, lack of client knowledge of services, and commitment to the pilot program by staff.

Conclusions: Implementation of a “warm handoff” is an instrumental tool for organizations to incorporate within their MIHP programs which may increase enrollment, subsequent visit, and revenue.

Available for download on Sunday, April 21, 2024