Communication With Staff During Hospitalization for Childbirth: The Patient's Perspective [1R]

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Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores impact hospital reimbursement. Patient-provider communication is a key driver of these scores. We explored the role of communication in childbirth hospital admissions from the pregnant woman's perspective.


We performed a systematic and comprehensive literature search regarding patient-reported outcomes (PROs) in childbirth, organized them into categories, and mapped them to a conceptual framework. In collaboration with a community partnership of clinicians and childbirth advocates, we held focus group sessions among pregnant and recently pregnant women from different racial/ethnic and socio-economic populations in Los Angeles County to determine women's priorities among these categories. Sessions utilized a standardized script for facilitators and were recorded, transcribed, and translated as needed. Using ATLAS.ti, responses were organized into themes and mapped to the categories.


Nineteen categories of PROs were identified, including clinical outcomes and processes of care, eg, labor and pain management, and patient-provider communication. For the 6 focus groups (N=41), communication was the most prevalent theme identified, and related concerns were associated with negative childbirth experiences. Among Spanish speakers, concerns included not being understood, and translator availability. African-American women acknowledged being understood; however, they felt ignored and placated. Medicaid-insured women voiced a lack of privacy when communicating with providers.


Communication with hospital staff was the principal concern during childbirth for a diverse sample of women; these concerns varied by race/ethnicity and insurance status. As maternity patients contribute to HCAHPS scores, strategies for addressing these concerns are critical for childbirth hospitals.

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