320 Obstetric clinician needs assessment for a postpartum patient navigation program for low-income patients

Abstract

Patient navigation, or the use of trained non-clinician personnel to reduce barriers and facilitate health care access, has been demonstrated to improve health and reduce disparities in non-obstetric populations, but is not yet widely used in obstetric and postpartum care. Our objective was to understand obstetric clinician perspectives on how to implement navigation to optimize care for low-income patients. In this qualitative study, focus groups were conducted with obstetrician faculty, fellows, residents, nurses, and social workers who care for low-income pregnant and postpartum patients in a tertiary healthcare center. Semi-structured interview guides were used to conduct focus groups on clinicians’ views about navigation and navigators, their recommendations for navigator training, and their perspectives on how navigators can be most effective. Analysis of themes from transcribed sessions was based on the constant comparative method. Twenty-six obstetric providers participated in 6 focus groups in which they discussed key elements for a successful obstetric or postpartum navigation program. Major navigation implementation themes included ideal navigator attributes, the training that would be most beneficial, and the services they could render (Table). Specifically, key navigator attribute themes included consistency, relatability, supportive manner, and advocacy. Training recommendations included learning the healthcare system, identifying where to obtain resources, and learning basic health education. Suggested services were broad, ranging from traditional care coordination to specific educational and resource-driven tasks. Clinicians also offered a framework for a flexible patient risk assessment to promote tailored navigation services (Figure). Obstetric clinicians perceive patient navigation to be a potentially beneficial resource to support low-income patients and offered recommendations on navigator training and services. Understanding clinician needs and preferences is essential to integration of patient navigator programs into obstetrical practice.View Large Image Figure ViewerDownload Hi-res image Download (PPT)