Tully Kristin P
Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Front Health Serv. 2024 Dec 10;4:1473848. doi: 10.3389/frhs.2024.1473848. eCollection 2024.
Centering birthing parents is critical for improving reproductive health policies and practices. This study investigates patient perspectives on measuring the quality of perinatal care.
A cross-sectional qualitative research study was conducted at an academic medical center in the Southeastern United States. Individuals who had recently given birth participated in audio-recorded interviews between May 2020 and September 2020. This analysis addresses the research question, "If we were providing quality healthcare for families, how would we know?" Transcribed and translated responses were inductively coded to develop categories and identify themes.
Forty birthing parents participated in the study. Metrics, timing, and process were identified as important components of meaningfully measuring the quality of perinatal care. Recommended metrics included asking patients whether their health priorities were addressed. Additional metrics of importance were whether coping strategies were provided, the clarity of information provided, patient comprehension of health information, the extent to which care planning was collaborative among patients and their healthcare team members, whether clinicians alleviated patient doubts, patient feelings of being taken care of, healthcare team mannerisms, clinician demonstrations of respect for patient autonomy, and postpartum visit attendance. With regard to timing, patients desired that their healthcare team members "check-in" with them as part of an ongoing, direct dialog. Birthing parents also wanted opportunities to provide feedback soon after encounters. As part of a robust measurement process, they wanted to share their insights with someone who was not a part of their healthcare team, for maintaining confidentiality. The patients desired a "serious platform" with accessible methods for all birthing parents to be able to convey nuanced accounts of their care. They also wanted to hear from the healthcare institutions about their feedback. Birthing parents sought assurances for their perinatal care feedback to be de-identified to protect them from potential retaliation. The participants recognized that they might need to utilize healthcare services from the same institution and individuals in the future.
Birthing parents expressed desire for their perinatal healthcare experiences to be understood. Meaningful quality measurement may be promoted through transparent and multimethod opportunities for patients to securely share insights. In addition to healthcare systems communicating assurances of patient confidentiality, institutional feedback in response to patient-reported experiences is recommended.
以生育父母为中心对于改善生殖健康政策和实践至关重要。本研究调查了患者对围产期护理质量衡量的看法。
在美国东南部的一家学术医疗中心进行了一项横断面定性研究。2020年5月至2020年9月期间，近期分娩的个体参与了录音访谈。该分析解决了研究问题：“如果我们为家庭提供高质量的医疗保健，我们如何知晓？”对转录和翻译后的回答进行归纳编码，以形成类别并确定主题。
40位生育父母参与了该研究。指标、时机和过程被确定为有意义地衡量围产期护理质量的重要组成部分。推荐的指标包括询问患者其健康优先事项是否得到解决。其他重要指标包括是否提供了应对策略、所提供信息的清晰度、患者对健康信息的理解、护理计划在患者及其医疗团队成员之间的协作程度、临床医生是否消除了患者的疑虑、患者被照顾的感受、医疗团队的举止、临床医生对患者自主权的尊重表现以及产后访视的出席情况。关于时机，患者希望其医疗团队成员作为持续直接对话的一部分与他们“联系”。生育父母还希望在每次接触后不久有机会提供反馈。作为一个健全的衡量过程的一部分，他们希望与非其医疗团队成员的人分享自己的见解，以保持保密性。患者希望有一个“严肃的平台”，采用所有生育父母都能使用的方法，以便能够传达其护理的细微差别。他们还希望听取医疗机构对他们反馈的意见。生育父母寻求保证其围产期护理反馈将被匿名化，以保护他们免受潜在的报复。参与者认识到他们未来可能需要利用同一机构和人员提供的医疗服务。
生育父母表示希望其围产期医疗保健经历能得到理解。通过为患者提供透明且多方法的安全分享见解的机会，可能会促进有意义的质量衡量。除了医疗系统传达患者保密的保证外，建议对患者报告的经历给予机构反馈。
