Maternity Care Moving from Vision to Action through the TMC Partnership!
In this Issue: Honor Mother's Day, protect maternal health
| Projects to collect and analyze data, improve care coordination, and reform payment systems
| Major national initiatives align with maternity care reform
| Preventing recurrent preterm birth |
This Mother's Day, join the fight to help make sure no mother dies unnecessarily during pregnancy and birth. While maternal mortality is a crisis worldwide, the U.S. rate ranks behind 33 other countries, and a new report of a multi-year, state-wide confidential enquiry of maternal deaths in California
found that more than a third of these deaths are likely preventable. The Maternal Health Accountability Act of 2011 (HR 894
), recently introduced in the House by Representative Conyers would provide grant funding for more states to establish maternal mortality review committees to examine pregnancy-related deaths and to identify ways to reduce maternal mortality rates. The bill also includes provisions to address severe maternal morbidity ("near misses") like the case TMC
Project Director, Amy Romano, writes about in her recent article, Mother's Day Manifesto: Blood, Tears, Toil, and Sweat
. (Amnesty International has a site
offering ideas for maternal health advocacy, including ways to support the Maternal Health Accountability Act and toolkits to raise awareness about maternal mortality in your community.)
Preventable maternal deaths are the tragic culmination of system failures that affect all childbearing women. Through the Transforming Maternity Care Partnership
, Childbirth Connection is working to create a system that reliably delivers safe, effective, and woman-centered care. We know that through the coordinated work of all stakeholders, we can achieve the 2020 Vision for a High-Quality, High-Value Maternity Care System
. We thank all of you for doing your part, and honoring the health and wellbeing of all mothers.
Take Action: Help Transform Maternity Care
Looking for more ways to get involved in maternity care quality improvement? The Transforming Maternity Care Action Center offers recommendations for all stakeholders.
Commit to taking one action today that will help improve maternity care in your community.
Good News from the Field: Partners Putting the Blueprint into Action
Recent additions to the Transforming Maternity Care Directory model innovative approaches to data collection and analysis, coordination of care, and payment reform
The Transforming Maternity Care Directory
features quality improvement efforts that users can browse by Blueprint area
or by quality improvement strategy
. Here are just a few projects recently added to our directory:
Obstetrical Clinical Outcomes Assessment Program (OB COAP)
: OB COAP is a clinician-led data collection and analysis initiative that uses chart-abstracted data of the variables relating to the management of a pregnant woman who delivers in the state of Washington. Data from the 6-month pilot phase have shed light on the associations among cesarean section, early labor admission, BMI, elective induction, and breastfeeding. Learn more
Louisiana Birth Outcomes Initiative
: The Louisiana Birth Outcomes Initiative is a state-wide effort coordinated by the Department of Health and Hospitals. This multi-stakeholder initiative creates mechanisms and incentives for progress in four major areas: quality and safety, interconception care, behavioral health, and performance measurement. This project was the subject of the April 2011 TMC Webinar
. Learn more
Minnesota Legislative Action to Establish Pregnancy Care Homes and Payment Reform
: This legislation would alter the organization of and payment for maternity services by: creating a mechanism to deny Medicaid payment for elective deliveries before 39 weeks, bundling payment for the full episode of maternity care for low-risk women, enabling access to midwives and birth centers providing high-quality, high-value care, and developing standards and a certification process for "pregnancy care homes." Learn more
Are you involved with a quality improvement effort?
Please add it to our growing TMC Directory
Consider This: Resources to Expand Your Vision for Improvement
Upcoming webinar will feature two major national initiatives that provide opportunities for maternity care improvement
Last month saw the launch of two major initiatives to improve U.S. healthcare. The National Quality Strategy establishes national priorities for achieving better care, healthy communities, and affordable care:
The Partnership for Patients provides priorities, strategies, and resources for improving patient safety in multiple focal areas including obstetrical care. The goal of the public-private partnership is to reduce the number of preventable obstetrical adverse events by half by 2013.
Next Tuesday, May 10, join a webinar exploring how individuals and organizations working to improve maternity care can leverage these and other major national quality initiatives. This free webinar, the latest in Childbirth Connection's TMC Topics series, will feature Karen Adams, PhD, MT, vice president of national priorities at the National Quality Forum.
Register for this webinar today
Ensuring that each person and family is engaged as partners in their care.
Promoting effective communication and coordination of care.
Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease.
Working with communities to promote wide use of best practices to enable healthy living.
Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models.
Cause for Optimism: Maternity Care Moving in the Right Direction
Intermountain Healthcare's recurrent preterm birth consultation clinic is associated with improved care, outcomes
Intermountain Healthcare established a recurrent preterm birth (PTB) clinic in 2008 to provide standard consultative services to women with prior spontaneous PTB. Eligible women are referred by their primary obstetric care provider to the clinic, where they receive three prescribed visits, at 10-18 weeks', 19-24 weeks', and 28-32 weeks' gestation, with additional visits as clinically indicated and remaining care provided in the usual setting. The consultation clinic offers coordinated, personalized screening, counseling, and treatment according to an evidence-based standard protocol. In a retrospective cohort study comparing eligible women who were referred to the recurrent PTB prevention clinic (n=70) with those who received usual care (n=153), recurrent PTB prevention clinic patients had increased utilization of resources, had lower rates of recurrent spontaneous PTB (48.6% vs 63.4%), delivered later (mean 36.1 vs 34.9 weeks), and had lower rates of composite major neonatal morbidity (5.7% vs 16.3%). Read more.