839: Feeling heard: optimizing the antepartum inpatient experience

Abstract

To ascertain predictors of patient satisfaction with antepartum admission experiences. We describe a longitudinal cohort study of women admitted for at least 96 hours to the antepartum service of a large university hospital between 2011 and 2019. Participants completed a survey about experiences including demographics, pregnancy outcomes, provider interactions, perceived needs, and satisfaction with their stay. Descriptive statistics, ANOVA, and multiple regression characterized responses and assessed for associations with our dependent variable of overall patient experience (rated 1-10; 10=best). 408/740 surveys were returned (55.1% response rate). 298 met inclusion criteria and were analyzed. Mean experience rating (ER) was 8.4 (SD=1.7). ER correlated directly with age (P< 0.01); older patients gave higher ratings. This was the only significant predictor in a multivariate model of ER based on demographics (age, parity, employment status, relationship status, ethnicity). There was no significant ER variation with admission indication (bleeding, PPROM, preterm labor, hypertensive disease; P=0.14) or outcome (IUFD/termination, neonatal demise, extended NICU stay, preterm birth without extended stay, term birth; P=0.32). Concern for financial hardship or difficulty making arrangements for home/work was associated with lower ER (P< 0.01). Conversely, feeling supported by partners (P< 0.01) and providers (P< 0.01) was directly correlated with better ER. Though provider support was correlated with provider listening ratings, listening skills had a stronger relationship with ER (R=0.52 versus R=0.45). In a model of patient experience including the aforementioned contributory factors, only provider communication and partner support remained significant (Figure 1). The most important contributors to patients’ satisfaction with antepartum experiences are feeling listened to by providers and partner support. Optimizing patient-provider communication during antepartum admissions should be a critical focus of inpatient high-risk obstetric care.