Quality and satisfaction with care following changes to the structure of obstetric care during the COVID-19 pandemic in a safety-net hospital in Georgia: Results from a mixed-methods study

• Published in: Journal of the National Medical Association Vol. 114; no. 1; pp. 94 - 103
• Main Authors: Stanhope, Kaitlyn K, Piper, Kendra, Goedken, Peggy, Johnson, Tatyana, Joseph, Naima T, Ti, Angeline, Geary, Franklyn, Boulet, Sheree L
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2022; Elsevier Limited; National Medical Association. Published by Elsevier Inc
• Subjects: COVID-19; COVID-19 - epidemiology; Emergency medical care; Female; Georgia - epidemiology; Hospitals; Humans; Interviews; Medical records; Medical research; Mixed methods research; Obstetrics; Pandemics; Patients; Perinatal care; Personal Satisfaction; Pregnancy; Prenatal care; Qualitative research; Quality of health care; Questionnaires; Safety-net Providers; SARS-CoV-2; Telemedicine; Telemedicine - methods; Ultrasonic imaging; Womens health; Georgia; United States > US; Qualitative research; COVID-19; Telemedicine; Quality of health care; Perinatal care
• ISSN: 0027-9684; 1943-4693
• DOI: 10.1016/j.jnma.2021.12.017

To understand perceived quality of obstetric care following changes to the structure of care in a safety-net institution during the COVID-19 pandemic.
We conducted a mixed-methods study including a web-based survey (n = 67) and in-depth interviews (n = 16) between October 2020 and January 2021. We present a descriptive analysis of quantitative results and key qualitative themes on reactions to changes and drivers of perceived quality.
Reported quality was high for in-person and phone visits (median subscale responses: 5/5). Respondents were willing to include phone visits in care for a future pregnancy (77.8% (49)) but preferred in-person visits (84.1% (53)). In interviews, provider communication was the key driver of quality. Respondents found changes to care to be inconvenient but acceptable.
To improve satisfaction with changes to care, health systems should ensure that relationship building remains a priority and offer patients information about the reason behind changes.