CO-DESIGNING AN IMPROVED PRENATAL EXPERIENCE WITH DIGITAL VISIT PREPARATION

Abstract

Objective: Increased prenatal care satisfaction is associated with positive clinical and business outcomes. Despite a link between pre-visit preparation interventions and patient satisfaction, little is known about the development of digital pre-visit interventions to improve prenatal patient satisfaction. Methods: A two-phase approach was employed. In the first phase, a mixed-methods survey was deployed to establish determinants of patient satisfaction, to identify unmet patient needs, determine current preparation practices and determine what visit patients felt the least prepared for. A convenience sample of 87 prenatal patients completed a self-administered survey on a tablet within 4 weeks of their estimated due date. In the second phase, a combination of participant interviews and staff workshops followed a Design Thinking methodology to co-design a prototype intervention to help patients prepare for their visit. Results: Of the participants surveyed, 94.1% reported feeling satisfied with their prenatal care. Visit preparedness was found to be a statistically significant predictor of overall satisfaction. Preparedness was lowest in early pregnancy and for primigravida patients. Patients reported a mismatch between high informational needs and low visit frequency in early pregnancy. To fulfill their information needs, participants conducted frequent research on their pregnancy, often using digital resources such as websites, peer-forums, mobile applications and social media. Participants reported low satisfaction with system characteristics of their care, citing the wait time needed to see their provider, time spent in the waiting room and a lack of flexibility in appointment scheduling as pain points in their care. Utilizing a Design Thinking approach, a prototype digital on-boarding package was co-developed with patients and clinic staff. Conclusions for Practice: Implementation of a digital on-boarding package for patients ahead of their first visit has the potential to fulfill informational needs and set expectations for their care journey, which in turn can increase preparedness and satisfaction.