Postpartum Readmission for Hypertension: The Patient Experience [ID: 1377602

Abstract

INTRODUCTION: Hypertensive disorders of pregnancy (HDP) are the most common cause of postpartum readmission. Prior research has led to the creation of clinical guidelines for postpartum management; however, the patient experience is often missing from this work. The objective of this project is to understand the perspective of patients readmitted for postpartum hypertension. METHODS: Institutional review board committee approval was obtained for the study. This was a qualitative study with data generated through semistructured interviews. Patients readmitted with postpartum HDP at an urban academic medical center were approached and consented for a single interview. The same researcher conducted all interviews and patient recruitment continued until thematic saturation was reached (n=9). Two coders coded all interviews using NVivo software with both deductive and inductive coding processes. Discrepancies were discussed and resolved with consensus. Researchers identified themes through grounded theory and were reflexive in their thematic generation. RESULTS: Five themes were generated through the grounded theory analysis: Every pregnancy is different, symptoms of preeclampsia are easily dismissed or often not taken seriously, miscommunication regarding medical changes can hinder patient care, readmission logistics are not baby-friendly, and patient well-being improved when conversations acknowledged the struggles of readmission. CONCLUSION: A qualitative research process revealed patient-identified gaps in care that may have led to readmission for HDP. The specific recommendations that emerge from these themes include: addressing barriers to blood pressure management prior to discharge, improving postpartum discharge follow-up, providing newborn care coordination, and improving counseling on the risk of postpartum preeclampsia during discharge. Incorporating these patient perspectives in hospital discharge policy can be helpful in creating patient-centered systems of care and may help reduce rates of readmission.