Understanding barriers and facilitators to implementation of a patient safety bundle for pregnancy-related severe hypertension in 3 North Carolina outpatient clinics: a qualitative study

Findings highlight the importance of community-engaged approaches. Further, clinic staff regarded Bundle implementation as crucial for the outpatient setting. Identified barriers suggest that strategies should address systemic social supports (i.e., transportation, childcare) and improve access to and use of home blood pressure monitoring. Identified facilitators support improving communication, increasing clinic champion engagement, enabling systems for identifying at-risk patients, and training staff on accurate blood pressure measurement. Successful Bundle implementation requires addressing systemic barriers to delivering respectful care, such as limited time with patients.