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CC BY 4.0 · AJP Rep
DOI: 10.1055/a-2788-9872
Original Article

Risk Stratification of Postpartum Patients with Hypertensive Disorders of Pregnancy to Telehealth Follow-up: A Quality Improvement Project

Authors

  • Ariana Banuelos

    1   Obstetrics and Gynecology (Baldwin Park), Kaiser Permanente Southern California, Pasadena, United States (Ringgold ID: RIN82579)

  • Kalin Ellison

    2   Obstetrics and Gynecology, Mount Sinai West Medical Center, New York, United States (Ringgold ID: RIN159954)

  • Weirui Xiao

    3   Obstetrics and Gynecology, University of California Los Angeles, Los Angeles, United States (Ringgold ID: RIN8783)

  • Patricia Chavez

    4   Medicine, Division of Cardiology, Yale School of Medicine, New Haven, United States (Ringgold ID: RIN12228)

  • Diana Wolfe

    5   Obstetrics and Gynecology, Montefiore Einstein Hospital, New York, United States (Ringgold ID: RIN2013)

  • Anna Bortnick

    6   Medicine, Division of Cardiology, Montefiore Einstein Hospital, New York, United States (Ringgold ID: RIN2013)

  • Kavita Vani

    7   Obstetrics & Gynecology and Women's Health, Montefiore Einstein Hospital, New York, United States (Ringgold ID: RIN2013)

Supported by: National Center for Advancing Translational Sciences K12TR004411
Supported by: National Heart, Lung, and Blood Institute K23 HL146982
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Background: Guidelines recommend 3-day follow-up for severe hypertensive disorders of pregnancy (HDP) and 7–10 day follow-up for non-severe HDP, but implementation varies. Objective: To improve adherence to guideline-recommended postpartum follow-up by targeting provider discharge recommendations. A risk stratification tool incorporating HDP severity, maternal symptoms, and discharge blood pressure guided providers to recommend telehealth follow-up at 3, 5, or 7 days. We aimed to maintain 3-day recommendations for severe HDP and reduce unnecessary 3-day recommendations for non-severe HDP. Study Design: This quality improvement project was conducted at a single urban academic institution. The risk stratification tool was integrated into discharge workflows, and demographic, clinical, and telehealth follow-up data for pre- and post-intervention cohorts were abstracted from the electronic medical record and compared using summary statistics and bivariate analyses. Results: Cohorts were similar at baseline. After implementation, all patients with severe HDP continued to receive 3-day follow-up instructions. Among patients with non-severe HDP patients 3-day recommendations decreased from 100% to 31.1% (p<0.001), with a corresponding decrease in 3-day telehealth scheduling. Scheduling for severe HDP did not improve. Conclusions: The tool improved guideline-aligned provider recommendations for postpartum HDP. Scheduling changes were limited, suggesting future efforts should target workflow and system processes..



Publication History

Received: 20 November 2025

Accepted: 14 January 2026

Accepted Manuscript online:
16 January 2026

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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