Search Results: MCHLine

Annotation: This report presents findings from the Maryland Maternal Health Innovation Program's (MDMOM) facility-based Severe Maternal Morbidity (SMM) Surveillance and Review program for 2024, analyzing 340 SMM events identified at participating hospitals following the passage of the Maternal Health Act of 2024 requiring all birthing hospitals in the state to participate in SMM surveillance beginning in 2025. The program uses a standardized case definition of intensive care unit admission and/or transfusion of four or more units of blood products for pregnant and postpartum patients up to 42 days postpartum. Hospital review committees analyzed events to determine preventability, identify contributing factors, and develop recommendations organized by the "5Rs" framework of readiness, recognition and prevention, response, reporting and system learning, and respectful care. The report documents that 32% of SMM events were potentially preventable, with obstetric hemorrhage being the most common primary cause, and includes demographic characteristics, delivery outcomes, and specific recommendations for preventing future severe maternal morbidity by cause and racial/ethnic disparities in SMM rates.

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Keywords: Maryland, Maternal morbidity, Maternal mortality, Population surveillance, Postpartum hemorrhage, Prevention, Standards

Annotation: This report presents findings from the Maryland Maternal Health Innovation Program's (MDMOM) facility-based Severe Maternal Morbidity (SMM) Surveillance and Review program for 2023, covering 279 SMM events identified at 27 participating hospitals representing more than 80% of births in the state. The program uses a standardized case definition of intensive care unit admission and/or transfusion of four or more units of blood products for pregnant and postpartum patients up to 42 days. Hospital review committees analyzed events to determine preventability, identify contributing factors, and develop recommendations organized by the "5Rs" framework of readiness, recognition and prevention, response, reporting and system learning, and respectful care. The report documents that 34% of SMM events were potentially preventable, with obstetric hemorrhage being the most common primary cause, and includes detailed analysis of demographic characteristics, timing of events, delivery outcomes, and specific recommendations for preventing future severe maternal morbidity by cause.

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Keywords: Maryland, Maternal morbidity, Maternal mortality, Population surveillance, Postpartum hemorrhage, Prevention, Standards

Annotation: The workbook outlines evidence-based practices for improving recognition of and response to obstetric hemorrhage, including hemorrhage risk assessments categorized as low, medium, and high risk that should be completed on admission, during labor, and post-delivery. It emphasizes the critical importance of quantification of blood loss using volumetric containers, weighing scales, or computerized image recognition rather than estimation, as postpartum hemorrhage occurs in about 40% of low-risk birthing people. The workbook presents the Alliance for Innovation on Maternal Health Patient Safety Bundle components, which include stage-based management plans, hemorrhage supply carts, immediate access to hemorrhage medications, standardized education for obstetric teams, multidisciplinary drills, and case review processes. It addresses Missouri-specific data showing obstetric hemorrhage as the fourth leading cause of pregnancy-related deaths from 2018-2020, with significant racial disparities in transfusion rates, and notes that between 54% to 90% of hemorrhage-related deaths are preventable. The workbook includes extensive resources for implementation including assessment tools, quantification worksheets, stage-based guidelines, simulation training materials, and patient debriefing forms, and provides trauma-informed guidance for supporting patients and families after hemorrhage events.

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Keywords: Emergency medical services, Hemorrhage, Missouri, Obstetric care, Obstetric complications, Postpartum hemorrhage, Quality improvement, State MCH Programs

Annotation: This web page from the Agency for Healthcare Research and Quality (AHRQ) provides clinical case scenarios and training materials for the AHRQ Safety Program for Perinatal Care, Phase 2. The scenarios illustrate 10 teamwork tools and strategies for improving care in obstetric hemorrhage and severe hypertension in pregnancy. The page includes two sets of education materials: (1) Tier 1 consists of eight short video-based emodules for each condition that introduce frontline clinicians to the teamwork tools and demonstrate their use; (2) Tier 2 provides PowerPoint slide sets with speaker notes to help Alliance for Innovation on Maternal Health (AIM) Team Leads disseminate the teamwork toolkit to frontline staff in their labor and delivery units, ideally through live workshops by a TeamSTEPPS master trainer.

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Keywords: Emergency medical services, Hemorrhage, Hypertension, Patient safety, Perinatal care, Postpartum care, Pregnancy complcations, Professional training

Annotation: The Postpartum Hemorrhage (PPH) Risk Assessment Table is designed to guide clinicians in assessing a patient's risk for postpartum hemorrhage at three critical time points: admission, pre-birth (approximately 30-60 minutes prior to giving birth), and upon admission to postpartum. Risk factors are categorized as low, medium, or high at each stage, with specific criteria listed for each category. The document provides guidance on adjusting a patient's risk level if they develop additional risk factors and outlines anticipatory interventions and blood bank orders appropriate for each risk category at the different assessment times. The table is intended to guide clinical decision-making in conjunction with clinical judgment and hospital policy.

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Keywords: Hemorrhage, Postpartum care, Resources for professionals, Risk assessment

Annotation: This strategies document provides guidance for hospitals and health systems on leveraging Electronic Health Record (EHR) tools to improve the early detection and prompt treatment of postpartum hemorrhage (PPH), a serious complication responsible for 11.2% of maternal deaths in the United States. The guidance details major topics focused on using the EHR, including embedding PPH risk assessments into obstetric workflows at critical stages of care, such as admission and transfer to postpartum, to categorize patients and recommend preventative supplies and medications. It further advocates for improving hemorrhage detection by integrating a Quantitative Blood Loss (QBL) calculator within the EHR, which helps clinicians accurately determine blood loss volume and avoids manual calculations during high-stakes clinical episodes. The strategies also cover using EHR reporting tools to monitor both compliance (such as C-section rates and frequency of QBL calculations) and patient outcomes (such as PPH rates and blood transfusion percentages), and incorporating C-section risk calculators to help reduce the risk of PPH by reducing non-medically indicated cesarean deliveries.

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Keywords: Diagnosis, Obstetrical care, Postpartum care, Postpartum hemorrhage, Therapeutics