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Examining Staff Perceptions of a Proactive, Telephonic Transition-of-Care Program for Pregnant People With Emergency
Stephanie M Garcia1,2, Lanelle Quzack1, Erica Hartmann3
1PolicyLab, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Health Services Research
|May 9, 2026
Summary
A pilot telephonic program successfully connected pregnant individuals with early pregnancy care after emergency department visits. Staff found the model feasible, highlighting patient-centered design and facilitator support, though staffing levels impacted sustainability.
Area of Science:
- Implementation Science
- Health Services Research
- Reproductive Health
Background:
- Pregnant individuals frequently use emergency departments (EDs), yet post-discharge care navigation models are understudied.
- Early pregnancy-related care initiation is crucial but faces systemic barriers.
- Proactive outreach models can bridge the gap between ED utilization and essential early pregnancy services.
Purpose of the Study:
- To evaluate staff perceptions of a telephonic transition-of-care pilot program.
- To assess the feasibility and acceptability of connecting pregnant individuals with ED utilization to early pregnancy care.
- To identify factors influencing the implementation and sustainability of this care model.
Main Methods:
- Qualitative descriptive study using thematic analysis guided by the i-PARIHS framework.
- Interviews conducted with 13 staff members (outreach champions, administrative champions, senior leaders) across six diverse pilot sites.
- Data collected between February and March 2024, following pilot implementation from August 2021 to June 2023.
Main Results:
- Staff perceived the transition-of-care model as acceptable and feasible.
- Strengths included patient-centered design, health information exchange (HIE) infrastructure, and external facilitator support.
- Barriers included inadequate outreach staffing, impacting sustainability; training in sensitive communication was a facilitator.
Conclusions:
- The pilot demonstrates preliminary evidence supporting proactive outreach for early pregnancy care post-ED utilization.
- The model offers a flexible blueprint adaptable to various clinical settings.
- This study contributes to the limited literature on innovations in early pregnancy care access.
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