Find State ESMs

Measure Status: Active

Evidence Level: There is limited research on this strategy related to this NPM. However, there is a growing body of evidence supporting this strategy related to other NPMs. In adapting this strategy, you may want to start with a pilot group, collect data, and evaluate to ensure impact with this topic area and your population group(s).

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Systems level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: To decrease maternal morbidity and mortality through widespread implementation of AIM safety bundles.

Numerator: Number of birthing facilities that have adopted safety bundles

Denominator: Total number of birthing facilities

Significance: AIM safety bundles have proven to decrease adverse outcomes associated with certain complications in the perinatal period.

Data Sources and Data Issues: MCH Program, DHHS, BOI

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategies were found.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Systems level of pyramid

Essential Public Health Services: 8. Build and support a workforce

Service Recipient: Activities directed to professionals

Goal: Increase the proportion of OB physicians and midwives who completed the education program on obstetric hemorrhage

Numerator: Number of OB physicians and midwives from participating hospitals in the AIM program who completed (within the last two years) an education program on obstetric hemorrhage

Denominator: Number of OB physicians and midwives affiliated with participating hospitals in the AIM program

Significance: According to the CDC, obstetric emergencies like severe bleeding and amniotic fluid embolism cause the most deaths at delivery. Implementing the AIM bundle for obstetric hemorrhage may reduce the risk of hemorrhaging at the delivery hospitalization, provide guidance for future work with the Peri-neonatal Quality Collaborative of RI, and inform the recommendation process for the Pregnancy Postpartum Death Review Committee.

Data Sources and Data Issues: AIM Program

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs for this NPM or search for other strategies or promising practices.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Systems level of pyramid

Essential Public Health Services: 9. Conduct evaluation, research and CQI

Service Recipient: Activities related to systems-building

Goal: Maintain high hospital participation in Illinois Perinatal Quality Collaborative (ILPQC) initiatives to improve obstetric care

Numerator: # Illinois perinatal hospitals participating in at least one ILPQC obstetric initiative during the calendar year

Denominator: # Illinois perinatal hospitals

Significance: This ESM will measure an activity of strategy #2-I: Support the Illinois Perinatal Quality Collaborative (ILPQC) as it seeks to implement obstetric and neonatal quality improvement projects initiatives in birthing hospitals. Since 2012, the Illinois Perinatal Quality Collaborative (ILPQC) has organized, supported, and facilitated statewide obstetric quality improvement projects, including implementation of patient safety bundles from the Alliance for Innovation in Maternal Health (AIM) and American College of Obstetricians and Gynecologists (ACOG). The Illinois Department of Public Health actively encourages birthing hospitals to participate in ILPQC initiatives and our state has had a high participation rate in past initiatives. To ensure the highest possible quality of care for all women in Illinois, it is important to maintain high hospital participation rates in obstetric ILPQC initiatives.

Data Sources and Data Issues: DATA SOURCE: Illinois Perinatal Quality Collaborative DATA ISSUES: Will work with ILPQC to define meaningful participation for each OB initiative

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs for this NPM or search for other strategies or promising practices.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Systems level of pyramid

Essential Public Health Services: 9. Conduct evaluation, research and CQI

Service Recipient: Activities related to systems-building

Goal: Increase the number of Louisiana birthing hospitals actively participating in evidence-based quality improvement initiatives to ensure safe, equitable, dignified births.

Numerator: Number of birthing hospitals in the Louisiana Perinatal Quality Collaborative that are actively and regularly submitting quality improvement data

Denominator: Number of all birthing hospitals in Louisiana

Significance: Emerging evidence suggests that hospital quality improvement initiatives can decrease NTSV cesarean delivery rate. Hospitals will implement the evidence-based Safe Reduction of Primary Cesarean Birth Patient Safety Bundle developed by the American College of Obstetricians and Gynecologists (ACOG) Alliance for Innovation on Maternal Health (AIM). ACOG AIM is a national data-driven maternal safety and quality improvement initiative based on interdisciplinary consensus-based practices to improve maternal safety and outcomes. Altimier L, Straub S, Narendran V. Improving outcomes by reducing elective deliveries before 39 weeks of gestation: a community hospital's journey.

Data Sources and Data Issues: LaPQC quality improvement database.

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Childbirth Education Classes". Find other NPM 2 patient-level strategies in MCHbest.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Direct services level of pyramid

Essential Public Health Services: 3. Inform and educate the public

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of first time pregnant women, fathers, families and support persons who have participated in the Lamaze International Evidence Based Labor Support Workshop.

Numerator: Number of first time pregnant women who participated in the Lamaze International Evidence Based Labor Support Workshop.

Denominator: Number of first time pregnant women.

Significance: Research shows that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of one-on-one support. A Cochrane meta-analysis states the association with a statistically significant reduction in the rate of cesarean deliveries.

Data Sources and Data Issues: Vital Statistics and Perinatal Partnership

Year: 2021

Unit Type: Count, Unit Number: 100000

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=alliance&NPM=2&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/2-cesarean.php).

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Systems level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: Increase the number of birthing hospitals participating in Michigan AIM

Numerator: Number of birthing hospitals participating in Michigan AIM

Denominator: N/A unit is count

Significance: For some medical indications, like placenta previa, cesarean birth is the safest delivery method and at times can be a life-saving measure. However, for most low-risk pregnancies, a cesarean delivery increases preventable risks for maternal mortality and morbidity outcomes. Such outcomes include mortality due to hemorrhage or morbidities such as infection, uterine rupture, cardiac arrest and anesthesia complications. A low-risk delivery is often defined as full-term (at least 37 completed weeks of gestation), singleton pregnancy (not a multiple pregnancy), with vertex presentation (head facing downward position in the birth canal). From 2012-2016, 15.3 % of pregnancy-related deaths in Michigan were due to hemorrhage and 54.2% of pregnancy-related deaths were deemed preventable. In 2018, the percentage of low-risk cesarean deliveries in Michigan was 28.7%, which is above the Healthy People 2020 goal (24.7%) and the average in the United States (25.9%). In addition, Michigan also has a higher percentage of low-risk cesarean deliveries in women of color. To address the high percentage of low-risk cesarean deliveries, including the disparate numbers among women of color, Michigan will increase the number of birthing hospitals participating in Michigan AIM. It is expected that birthing hospitals engaging and participating in Michigan AIM will experience improved birth outcomes.

Data Sources and Data Issues: Michigan AIM

Year: 2021

Unit Type: Count, Unit Number: 80

Measure Status: Active

Evidence Level: Strategy and ESM aligns with priority, however it is not in direct alignment with NPM (most aligned with NPM 3). See other ESMs for this NPM or find other NPM 2 hospital-level strategies in MCHbest.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Systems level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: To implement maternal levels of care as a standard throughout the state.

Numerator: Pilot the CDC Locate model

Denominator: Pilot the CDC Locate model

Significance: The implementation of this evidence-based model is aimed to ensure risk-appropriate care is provided to mothers in the perinatal period.

Data Sources and Data Issues: MCH Program, PRS/RSDs, BOI

Year: 2021

Unit Type: Text, Unit Number: Yes/No

Measure Status: Active

Evidence Level: No similar strategies were found.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Systems level of pyramid

Essential Public Health Services: 8. Build and support a workforce

Service Recipient: Activities directed to professionals

Goal: Increase the proportion of OB nurses who completed the education program on obstetric hemorrhage

Numerator: Number of OB nurses from participating hospitals in the AIM program who completed (within the last two years) an education program on obstetric hemorrhage

Denominator: Number of OB nurses affiliated with participating hospitals in the AIM program

Significance: According to the CDC, obstetric emergencies like severe bleeding and amniotic fluid embolism cause the most deaths at delivery. Implementing the AIM bundle for obstetric hemorrhage may reduce the risk of hemorrhaging at the delivery hospitalization, provide guidance for future work with the Peri-neonatal Quality Collaborative of RI, and inform the recommendation process for the Pregnancy Postpartum Death Review Committee.

Data Sources and Data Issues: AIM Program

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs for this NPM or search for other strategies or promising practices.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Systems level of pyramid

Essential Public Health Services: 9. Conduct evaluation, research and CQI

Service Recipient: Activities related to systems-building

Goal: Increase the proportion of births occurring in hospitals that are actively participating in Illinois Perinatal Quality Collaborative (ILPQC) initiatives to improve obstetric care

Numerator: # live births in Illinois hospitals participating in at least one ILPQC obstetric initiative during the calendar year

Denominator: # live births in Illinois hospitals

Significance: This ESM will measure an activity of strategy #2-I: Support the Illinois Perinatal Quality Collaborative (ILPQC) as it seeks to implement obstetric and neonatal quality improvement projects initiatives in birthing hospitals. Since 2012, the Illinois Perinatal Quality Collaborative (ILPQC) has organized, supported, and facilitated statewide obstetric quality improvement projects, including implementation of patient safety bundles from the Alliance for Innovation in Maternal Health (AIM) and American College of Obstetricians and Gynecologists (ACOG). The Illinois Department of Public Health actively encourages birthing hospitals to participate in ILPQC initiatives and our state has had a high participation rate in past initiatives. To ensure the highest possible quality of care for all women in Illinois, it is important to maintain high hospital participation rates in obstetric ILPQC initiatives.

Data Sources and Data Issues: DATA SOURCE: Illinois Perinatal Quality Collaborative, Birth Certificates DATA ISSUES: Will work with ILPQC to define meaningful participation for each OB initiative

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with Hospital Policies . Find other NPM 4.6 Hospital level strategies in MCHbest.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Systems level of pyramid

Essential Public Health Services: 6. Utilize legal and regulatory actions

Service Recipient: Activities related to systems-building

Goal: Increase the percentage of birthing hospitals that demonstrate active implementation of multiple evidence-based best practices that promote vaginal birth

Numerator: Number of hospitals achieving Louisiana Birth Ready Designation

Denominator: Number of birthing hospitals in Louisiana

Significance: While the Louisiana Perinatal Quality Collaborative (LaPQC) is not responsible for directly implementing evidence-based improvement strategies within birthing hospitals, the LaPQC incentivizes hospitals to implement these multi-component interventions through a designation program. Louisiana Birth Ready Designation requires hospitals to demonstrate improvement through: participation in collaborative learning; health disparity and patient partnership; policies and procedures; structures and education; and outcome and process measures. Hospitals awarded Designation must demonstrate active implementation of multiple evidence-based best practices that address common causes of maternal mortality and morbidity related to hemorrhage and hypertension, as well as practices that promote vaginal birth.

Data Sources and Data Issues: Internal program records

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Strategy and ESM aligns with priority, however it is not in direct alignment with NPM. See other ESMs for this NPM or find other NPM 2 provider-level strategies in MCHbest.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Systems level of pyramid

Essential Public Health Services: 3. Inform and educate the public

Service Recipient: Activities related to systems-building

Goal: To encourage birthing hospitals to provide post-birth messaging about the danger signs in the postpartum period and when to seek care.

Numerator: Number of birthing facilities that have received education on providing post-birth messaging

Denominator: Total number of birthing facilities

Significance: Raising awareness and education among new mothers on danger signs in the postpartum period and when to seek care can help prevent maternal morbidity and mortality.

Data Sources and Data Issues: MCH Program, PRS/RDSs, DHHS, BOI

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs for this NPM or search for other strategies or promising practices.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Systems level of pyramid

Essential Public Health Services: 3. Inform and educate the public

Service Recipient: Activities related to systems-building

Goal: To increase knowledge around maternal mortality and strategies that can be implemented to prevent adverse birth outcomes.

Numerator: Number of data briefs produced and disseminated

Denominator: One per year

Significance: Findings and insight provided by the MMMRC Committee on preventable maternal morbidity and mortality should be widely disseminated to encourage prevention efforts.

Data Sources and Data Issues: MCH Program, MMMRC Committee, MMMRC data analyst

Year: 2021

Unit Type: Text, Unit Number: Yes/No