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Published on: January 12, 2018
Improving care coordination for socially complex perinatal patients: A human-centered design study
Christina N Schmidt1, Benjamin S Alpers2,3, Devika Patel2,3
1Department of Obstetrics & Gynecology Mass General Brigham Boston Massachusetts USA.
Pregnancy (Hoboken, N.J.)
|August 14, 2026
Summary
Human-centered design revealed fragmented communication and system integration issues in perinatal care for socially complex patients. Improving information flow between clinical and community providers can enhance care coordination in safety-net systems.
Area of Science:
- Perinatal healthcare
- Human-centered design
- Healthcare systems analysis
Background:
- Care fragmentation in the perinatal ecosystem necessitates evaluating workflows and engaging diverse stakeholders.
- Human-centered design (HCD) is a methodology to identify patient and provider challenges in clinical workflows for actionable insights.
- This study applied HCD to understand perinatal care transitions in a safety-net system and identify barriers to care coordination for socially complex pregnant patients.
Purpose of the Study:
- To understand perinatal care transitions within a safety-net healthcare system.
- To identify barriers impacting care coordination for socially complex pregnant patients.
- To generate design opportunities for improving perinatal care coordination.
Main Methods:
- Conducted semi-structured interviews with patients, clinical providers (physicians, midwives, nurses, social workers), and community-based organization (CBO) staff.
- Utilized a human-centered design (HCD) approach for inductive thematic analysis of interview data.
- Included 42 participants across 34 interviews: 13 patients, 22 clinical providers, and 7 community/public health stakeholders.
Main Results:
- Identified fragmented communication and limited integration between clinical and community systems as key themes.
- Highlighted uncertainty in information-sharing policies and inconsistent substance-use protocol implementation.
- Revealed disruptions in continuity of care and variable discharge planning, leading to confusion and eroded trust.
Conclusions:
- Human-centered design identified critical challenges in perinatal care coordination for socially complex patients in safety-net settings.
- Strengthening informational continuity between clinical and community-based providers is crucial.
- Interventions focused on improved information flow hold promise for enhancing perinatal care delivery in safety-net systems.
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