Rationales (colored lines match specific colored rationale): Collaboration is often necessary to take care of postpartum readmit patients. In addition to nursing staff working with the providers, there is also support needed from Lactation consultants (meso) to assist these postpartum mothers and the nursing staff with breastfeeding and pumping. Some patients are not physically able to take care of their newborn during their readmission, so collaboration is needed to assist these patients with pumping to allow continued breastfeeding. For those patients able to take care of their newborns during the readmission period, it is crucial for the hospital and unit to have a policy on allowing rooming-in (meso) between the mother and infant. During high census periods (macro), especially during the summer on Labor and Delivery, there are often more antepartum and laboring patients being admitted. As postpartum readmission rates increase, more Labor and Delivery beds (micro) will be allocated for postpartum readmits. Postpartum readmissions are kept on the Labor and Delivery unit for closer monitoring and oftentimes one-on-one nursing support due to the severity of the patient’s diagnosis. Thus, more Labor and Delivery nurses (micro) are needed to care for these postpartum patients, which decreases the nurses available to take care of laboring patients, especially during high census times. A lack of adequate follow up care (macro) in the immediate postpartum period may lead to increased hospital readmission rates for postpartum mothers. This primarily may be due to a lack of surveillance and early intervention to complications during this period if the patient is unable to obtain follow up care in an office-setting with a healthcare provider. Many hospitals use readmission rates as a quality of care indicator (macro), which is usually also reported at a state and national level and for Medicare and Medicaid services. In cases where readmission may be preventable with early intervention, but a patient does not have access to follow up care, readmission rates may increase due to the patient seeking care at a hospital once their complications worsen. Again, if a patient does not have adequate access to follow up care (macro), they may unknowingly allow mild complications that could have been treated with early intervention to worsen to the case of hospitalization and readmission. The longer an individual waits to seek care, therefore allowing their issues to worsen, the greater the chance for increased morbidity and mortality. As maternal mortality rates have increased across the country (macro), it is an area of concern among intrapartum and postpartum patients. Sufficient access to care and early interventions to complications may be critical in helping to reduce these maternal mortality rates. Upon initial discharge from the hospital post-birth, patients should be sufficiently educated (micro) on when to follow up with their physician in the office, signs and symptoms to report to their doctor, and when to seek immediate medical assistance. The hope is that with sufficient patient education upon discharge, readmission rates will decrease by encouraging patients to seek early care with their physician in the office and not allowing their symptoms to worsen to the point that they will need to follow up in an emergency department or obstetrical triage department. However, patients who have a lack of follow-up care or do not obtain substantial patient education on initial discharge may seek treatment in an emergency department or obstetrical triage (meso). This then increases the number of postpartum patients in a triage area that is also assessing laboring and antepartum patients. Furthermore, maternal mortality rates (macro) may increase with longer waiting periods in emergency departments while patients are waiting to be seen to treat their postpartum complications. There are multiple ways to set patients up for success upon initial discharge from the hospital post-birth. In addition to thorough education (micro), nurses and physicians should be monitoring the patient’s vital signs and lab values (micro) prior to discharge to understand if there are any abnormal values that might indicate the beginning of postpartum complications. If we can catch these abnormal values prior to delivery, we might be able to provide early intervention and save the patient from being readmitted to the hospital following discharge. Another important factor is working with pharmacy (meso) to provide patients with crucial medications or monitoring equipment to take home with them when discharged from the hospital. This can save them a trip from obtaining these items post-discharge, especially for patients who have a lack of transportation (micro). For patients who have a lack of access to follow-up care (macro), the opportunity to take medications and a blood pressure cuff home with them might save them from complications later on by allowing early detection and treatment of problems while they are at home.