Patient and Provider Perceptions of a Patient Navigation Program to Improve Postpartum Care Among Publicly Insured Women

Abstract

Objective This study was aimed to assess patient and provider perceptions of a postpartum patient navigation program. Study Design This was a mixed-method assessment of a postpartum patient navigation program. Navigating New Motherhood (NNM) participants completed a follow-up survey including the Patient Satisfaction with Interpersonal Relationship with Navigator (PSN-I) scale and an open-ended question. PSN-I scores were analyzed descriptively. Eighteen provider stakeholders underwent in-depth interviews to gauge program satisfaction, perceived outcomes, and ideas for improvement. Qualitative data were analyzed by the constant comparative method. Results In this population of low-income, minority women, participants (n = 166) were highly satisfied with NNM. The median PSN-I score was 45 out of 45 (interquartile range [IQR]: 43–45), where a higher score corresponds to higher satisfaction. Patient feedback was also highly positive, though a small number desired more navigator support. Provider stakeholders offered consistently positive program feedback, expressing satisfaction with NNM execution and outcomes. Provider stakeholders noted that navigators avoided inhibiting clinic workflow and eased clinic administrative burden. They perceived NNM improved multiple clinical and satisfaction outcomes. All provider stakeholders believed that NNM should be sustained long-term; suggestions for improvement were offered. Conclusion A postpartum patient navigation program can perceivably improve patient satisfaction, clinical care, and clinic workflow without burden to clinic providers.

A Patient Navigation Model to Improve Complex Wound Care Outcomes

“…These provisions may help narrow existing healthcare disparities. Patient navigators can facilitate improved healthcare access and quality for underserved populations 33 . Through advocacy and care coordination, they can also address deep-rooted issues related to distrust in providers and the health system that often led to avoidance of health problems and nonadherence to treatment recommendations.…”

Primary Care Clinician Perspectives on Patient Navigation to Improve Postpartum Care for Patients with Low Income

“…In prior work, patients viewed navigation services positively and had improved health outcomes with navigator support. 18 , 23 With growing evidence that patient navigation services may be beneficial in the postpartum period, feedback on navigation services and training from key stakeholders in postpartum health care can help to facilitate effective implementation of navigation services. Previous work from our research group has assessed perspectives from obstetrics and gynecology-trained clinicians on postpartum patient navigation.…”

“…The guide was designed by the research team who has previous experience with assessing obstetrics and gynecology clinician perspectives on patient navigation and barriers to care in the postpartum period. 20 , 22 , 23 Given the known health inequities in the postpartum period, our study focused on the experiences and care processes among birthing individuals with low income. Topics discussed included navigator services that would decrease burdens faced by patients with low income and their health care clinicians.…”

Improving Postpartum and Long-Term Health After an Adverse Pregnancy Outcome: Examining Interventions From a Health Equity Perspective

“…Originally implemented for oncology, patient navigation is a barrier-focused, patient-centered intervention employing trained personnel to identify patient-level barriers and facilitate complete and timely access to health services 74,95. It has been adapted to postpartum care demonstrating preliminary success with improvements in postpartum visit attendance, receipt of contraception and depression screening, and high perceived utility among stakeholders 74,96,97. The principles of patient navigation as adapted to individuals with GDM are currently under investigation in an ongoing feasibility trial by our team designed to promote connectivity to primary care, enhance patient awareness of T2D risk after GDM, and engage patients in diabetes prevention activities 75…”