Identifying Health Systems Gaps as Perceived by Postpartum Patient Navigators at an Urban Academic Medical Center
Background: Although the postpartum period is an opportunity to promote long-term well-being and health systems usage, system complexities limit patients’ abilities to optimize their longitudinal health. Postpartum patient navigation, an intervention that assists individuals in navigating health sys...
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| Format: | Article |
| Language: | English |
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Mary Ann Liebert
2025-01-01
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| Series: | Women's Health Reports |
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| Online Access: | https://www.liebertpub.com/doi/10.1177/26884844251362313 |
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| author | Hannah M. Green Maya Daiter Viridiana Carmona-Barrera Laura Diaz Brittney Williams Ka’Derricka Davis Joe Feinglass Arjeme Cavens Charlotte Nizik Brigid M. Dolan Michelle A. Kominiarek William A. Grobman Lynn M. Yee |
| author_facet | Hannah M. Green Maya Daiter Viridiana Carmona-Barrera Laura Diaz Brittney Williams Ka’Derricka Davis Joe Feinglass Arjeme Cavens Charlotte Nizik Brigid M. Dolan Michelle A. Kominiarek William A. Grobman Lynn M. Yee |
| author_sort | Hannah M. Green |
| collection | DOAJ |
| description | Background: Although the postpartum period is an opportunity to promote long-term well-being and health systems usage, system complexities limit patients’ abilities to optimize their longitudinal health. Postpartum patient navigation, an intervention that assists individuals in navigating health systems, is a novel innovation that may mitigate barriers to longitudinal care. Methods: Within a recently completed randomized controlled trial (RCT), we conducted a secondary analysis of interviews with two navigators and a subset (N = 15) of navigated participants to describe gaps in the health care system. Semi-structured interview guides were used to conduct 11 sets of interviews with postpartum navigators. In the RCT, navigators supported publicly insured individuals for 1 year postpartum. Interviews focused on relationships with patients and care teams and reflections on health systems gaps which challenged care. Interviews were transcribed and analyzed using grounded theory. A randomly selected subset of interviews with navigated participants was analyzed to triangulate navigator-identified gaps. Results: Navigators identified three major gaps in the care system for postpartum individuals: overall health system challenges, postpartum care challenges, and gaps in the transition to primary care. Health system challenges included fragmentation within the hospital system, fragmentation across distinct health care institutions, high task burden for patients, and lack of clear communication between patients and care teams. Postpartum care challenges included operational and logistical errors in care and the transient nature of obstetric care. Gaps in the transition to primary care included a lack of emphasis on the importance of primary care, lack of administrative support in the transition, and lack of communication between care teams. Conclusions: Postpartum patient navigators elucidated health systems gaps that present challenges in maximizing the longitudinal well-being of birthing individuals. These results identify areas for systems improvements that could promote lifelong health. |
| format | Article |
| id | doaj-art-e65058b071ca41289fdeda25c4fb91af |
| institution | Kabale University |
| issn | 2688-4844 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Women's Health Reports |
| spelling | doaj-art-e65058b071ca41289fdeda25c4fb91af2025-08-20T03:56:46ZengMary Ann LiebertWomen's Health Reports2688-48442025-01-016169070010.1177/26884844251362313Identifying Health Systems Gaps as Perceived by Postpartum Patient Navigators at an Urban Academic Medical CenterHannah M. Green0Maya Daiter1Viridiana Carmona-Barrera2Laura Diaz3Brittney Williams4Ka’Derricka Davis5Joe Feinglass6Arjeme Cavens7Charlotte Nizik8Brigid M. Dolan9Michelle A. Kominiarek10William A. Grobman11Lynn M. Yee12Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island, USA.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.Background: Although the postpartum period is an opportunity to promote long-term well-being and health systems usage, system complexities limit patients’ abilities to optimize their longitudinal health. Postpartum patient navigation, an intervention that assists individuals in navigating health systems, is a novel innovation that may mitigate barriers to longitudinal care. Methods: Within a recently completed randomized controlled trial (RCT), we conducted a secondary analysis of interviews with two navigators and a subset (N = 15) of navigated participants to describe gaps in the health care system. Semi-structured interview guides were used to conduct 11 sets of interviews with postpartum navigators. In the RCT, navigators supported publicly insured individuals for 1 year postpartum. Interviews focused on relationships with patients and care teams and reflections on health systems gaps which challenged care. Interviews were transcribed and analyzed using grounded theory. A randomly selected subset of interviews with navigated participants was analyzed to triangulate navigator-identified gaps. Results: Navigators identified three major gaps in the care system for postpartum individuals: overall health system challenges, postpartum care challenges, and gaps in the transition to primary care. Health system challenges included fragmentation within the hospital system, fragmentation across distinct health care institutions, high task burden for patients, and lack of clear communication between patients and care teams. Postpartum care challenges included operational and logistical errors in care and the transient nature of obstetric care. Gaps in the transition to primary care included a lack of emphasis on the importance of primary care, lack of administrative support in the transition, and lack of communication between care teams. Conclusions: Postpartum patient navigators elucidated health systems gaps that present challenges in maximizing the longitudinal well-being of birthing individuals. These results identify areas for systems improvements that could promote lifelong health.https://www.liebertpub.com/doi/10.1177/26884844251362313patient navigationpostpartum caresystems improvementcare transition |
| spellingShingle | Hannah M. Green Maya Daiter Viridiana Carmona-Barrera Laura Diaz Brittney Williams Ka’Derricka Davis Joe Feinglass Arjeme Cavens Charlotte Nizik Brigid M. Dolan Michelle A. Kominiarek William A. Grobman Lynn M. Yee Identifying Health Systems Gaps as Perceived by Postpartum Patient Navigators at an Urban Academic Medical Center Women's Health Reports patient navigation postpartum care systems improvement care transition |
| title | Identifying Health Systems Gaps as Perceived by Postpartum Patient Navigators at an Urban Academic Medical Center |
| title_full | Identifying Health Systems Gaps as Perceived by Postpartum Patient Navigators at an Urban Academic Medical Center |
| title_fullStr | Identifying Health Systems Gaps as Perceived by Postpartum Patient Navigators at an Urban Academic Medical Center |
| title_full_unstemmed | Identifying Health Systems Gaps as Perceived by Postpartum Patient Navigators at an Urban Academic Medical Center |
| title_short | Identifying Health Systems Gaps as Perceived by Postpartum Patient Navigators at an Urban Academic Medical Center |
| title_sort | identifying health systems gaps as perceived by postpartum patient navigators at an urban academic medical center |
| topic | patient navigation postpartum care systems improvement care transition |
| url | https://www.liebertpub.com/doi/10.1177/26884844251362313 |
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