Find State ESMs

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: To ensure that pregnant women at high risk of poor maternal and neonatal outcomes are appropriately transferred to a Level III facility prior to delivery

Numerator: among very low birth weight births, # where mother was transported to delivery hospital prior to delivery

Denominator: among very low birth weight births, # where infant was transported to another hospital within 24 hours after delivery

Significance: This ESM will measure an output of strategy #3A: Maintain a strong system of regionalized perinatal care by supporting perinatal network administrators and outreach/education coordinators and identifying opportunities for improving the state system Ideally, hospitals would transport women prior to delivery to ensure risk-appropriate care for both the mother and newborn infants. Transports of infants after delivery may indicate The percent of women transported prior to delivery is an important process measure of the outputs of the perinatal system. It will track how whether changes initiated through policy and quality improvement projects are affecting the percent of women transported to a risk-appropriate facility. By ensuring high-risk pregnant women are appropriately transferred to Level III facilities, we would anticipate that the percent of infants delivered in risk-appropriate facilities (NPM #3) would increase.

Data Sources and Data Issues: DATA SOURCE: birth certificates DATA ISSUES: among very low birthweight (350-1499g) infants delivered in Illinois birthing hospitals or St. Louis, MO hospitals that are part of the Southern Illinois network

Year: 2021

Unit Type: Ratio, Unit Number: 1

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs for this NPM.

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

Service Type: Systems level of pyramid

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

Service Recipient: Activities directed to professionals

Goal: Increase proportion of Medicaid enrolled and billing midwives to at least 90% by 2022.

Numerator: Number of direct entry, licensed midwives who are enrolled and accepting Medicaid patients in NM

Denominator: Number of direct entry, licensed midwives in NM

Significance: Home births or births attended by a licensed midwife are less likely to be invasive or involve non-medically indicated induction, C-section or other medicalized procedures when not needed.

Data Sources and Data Issues: Birth certificate, MANA, PRAMS and/or hospitalization data may be used

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM is population-based (measures access to/receipt of care), thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

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

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: VLBW babies will be born in a Level III+ Neonatal Intensive Care Unit

Numerator: Number of VLBW babies delivered at a Level III or IV Hospital

Denominator: Number of VLBW babies

Significance: Infants born in appropriate level hospitals have a decreased risk of adverse outcomes

Data Sources and Data Issues: VSA Data

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn't align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

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

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 availability of Level III beds in NICUs.

Numerator: Number of very low birthweight infants

Denominator: Number of Level III NICU beds

Significance: To ensure that the state has the capacity for all very low birthweight infants to be born in a Level III NICU.

Data Sources and Data Issues: Florida CHARTS

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM is population-based (measures access to/receipt of care), thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

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

Service Type: Enabling services level of pyramid

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

Service Recipient: Activities directed to professionals

Goal: To increase percent of Tennessee birthing hospitals participating in perinatal quality collaborative projects

Numerator: Number of Tennessee birthing hospitals participating in perinatal quality collaborative projects

Denominator: Number of Tennessee birthing hospitals

Significance: The Tennessee Initiative for Perinatal Quality Care seeks to improve health outcomes for mothers and infants by implementing data-driven provider- and community-based performance improvement initiatives. Current projects being implemented include initiatives targeted to neonatal abstinence syndrome, opioid use disorder, sleep-related infant death, and several maternal hypertension. More Tennessee birthing hospitals participating in these projects will ensure that the best evidence-based clinical practices are being allied to pressing public health facing mothers and infants. Ultimately, a higher percentage of birthing hospitals with these initiatives in place will lead to improved infant health outcomes and reduced disparities in access and treatment.

Data Sources and Data Issues: Family Health and Wellness tracking tool

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM is population-based (measures access to/receipt of care), thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

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

Service Type: Systems level of pyramid

Essential Public Health Services: 2. Investigate and address health problems

Service Recipient: Activities directed to families/children/youth

Goal: Improve pregnant women who receive prenatal care beginning in the first trimester

Numerator: Number of low birth weights in the hospital

Denominator: Total number of livebirths

Significance: Improve perinatal outcomes

Data Sources and Data Issues: Public health and CHC

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Adopt Standard Definitions for Hospital Level of Care" (). Find other NPM 3 system-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: 9. Conduct evaluation, research and CQI

Service Recipient: Activities related to systems-building

Goal: All delivery hospitals in Indiana are providing risk-appropriate care as determined by Indiana rules based on the ACOG consensus statement.

Numerator: Number of hospitals who have been surveyed by MCH hospital surveyors

Denominator: Number of birthing hospitals in Indiana.

Significance: The goal of levels of perinatal care is to reduce infant mortality, including existing disparities, by encouraging the growth and maturation of systems for the provision of risk-appropriate care specific to maternal health needs. To standardize a complete and integrated system of perinatal regionalization and risk-appropriate maternal care, this classification system establishes levels of maternal care that pertain to basic care (level I), specialty care (level II), sub-specialty care (level III), and regional perinatal health care centers (level IV). The level of care designation process will provide a level of confidence that infants born in Indiana are delivered and cared for post delivery at a hospital that can best support their gestational age and medical diagnosis and related risk.

Data Sources and Data Issues: MCH Internal Data collected by hospital survey staff

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "State Policies/Guidelines" . Find other NPM 3 state-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: 9. Conduct evaluation, research and CQI

Service Recipient: Activities directed to professionals

Goal: Convene the delivering hospitals to share data and discuss the Alabama Perinatal Regionalization System Guidelines.

Numerator: Number of delivering hospitals represented at the meeting

Denominator: Number of delivering hospitals in Alabama

Significance: Related to Maternal, Infant, and Child Health (MICH)-33: Increase the proportion of very low birth weight (VLBW) infants born at Level III hospitals or subspecialty perinatal centers. Low birth weight or premature infants born in risk-appropriate facilities are more likely to survive. Multiple studies indicate VLBW infant mortality is lower for infants born in a Level III center (higher level of care), and higher for infants born in non-Level III centers. Implementation of this measure ensures that a system of regionalized care is implemented and VLBW infants are referred to the appropriate level of care facility before delivery.

Data Sources and Data Issues: Alabama's State Perinatal Program's Meeting Sign-In Sheets

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Adopt Standards Defintions for Hospital Level of Care" . Find other NPM 3 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: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: The baseline value for this measure will be determined in 2021, after regulations are adopted. The program has set a target to update designations for 50% of hospitals within the first year, and 100% within 5 years.

Numerator: Number of birthing hospitals with final level of perinatal care designation

Denominator: Number of birthing hospitals

Significance: NYS historically has been a leader in establishing systems of perinatal regionalization, with consistently high performance in this measure. Building on that success, the Title V program is currently engaged in a multi-year effort to expand and update perinatal regionalization standards and designations for the state’s birthing hospitals and centers. As this work progresses, it is essential to closely monitor the success of designating birthing hospitals in accordance with updated regulations as well as performance and outcome measures to ensure that quality of care and key health outcomes are maintained or improved.

Data Sources and Data Issues: Data for this measure will come from hospital surveys and site visit reports from IPRO/NYSDOH staff

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Statewide Assessment of Personnel, Resources, and Capabilities of Birthing Facilities". Find other NPM 3 system-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: 9. Conduct evaluation, research and CQI

Service Recipient: Activities related to systems-building

Goal: By 2025, 100% of birth facilities will have levels of neonatal and maternal care documented in an effort to ensure risk appropriate care is provided for infants and mothers.

Numerator: Number of birthing facilities in NC which have completed the CDC Levels of Care Assessment Tool (CDC LOCATe) and been assigned appropriate maternal and neonatal levels of care within the past five years

Denominator: Total Number of birthing facilities in NC

Significance: Ensuring that infants are born at facilities that are equipped to meet the need of both the infant and the mother is important to improve both maternal and neonatal outcomes. The LOCATe tool is a hospital survey on obstetric and neonatal practices and services which classifies maternal and neonatal levels of care based on responses to survey questions that are tied to criteria found in the 2015 ACOG/SMFM maternal levels of care and the 2012 AAP neonatal levels of care.

Data Sources and Data Issues: The Women's Health Branch (WHB) will keep an internal log of birthing facilities that complete the LOCATe tool within each calendar year. The WHB is working with the Division of Health Services Regulations to update the existing neonatal rules and to develop maternal health rules.

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Statewide Assessment of Personnel, Resources, and Capabilities of Birthing Facilities". Find other NPM 3 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: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: To decrease preterm and low birth weight births and to improve birth outcomes

Numerator: Number of Arkansas birthing hospitals that completed the CDC Levels of Care Assessment Tool (CDC LOCATe)

Denominator: Number of Arkansas birthing hospitals

Significance: A significant cause of infant mortality is prematurity. Maternal and newborn intensive care for very premature deliveries and births has reduced mortality for those most at risk. Regionalization of NICUs seeks to increase the likelihood that a mother and infant receive risk-appropriate medical care in order to reduce maternal and infant morbidity and mortality, and to minimize cost.

Data Sources and Data Issues: Family Health Branch administrative records

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Adopt Standard Definitions for Hospital Level of Care". Find other NPM 3 system/state-level strategies in MCHbest.

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

Service Type: Enabling services level of pyramid

Essential Public Health Services: 1. Assess and monitor population health

Service Recipient: Activities related to systems-building

Goal: Verify all Georgia birthing hospitals are operating at the level of care designation authorized through the DCH Certificate of Need program.

Numerator: Number of hospitals verified annual through the Neonatal Center Designation Program

Denominator: Count

Significance:

Data Sources and Data Issues: Very low birth weight infants (<1,500 grams or 3.25 pounds) are the most fragile newborns. Although they represented less than 2% of all births in 2010, VLBW infants accounted for 53% of all infant deaths, with a risk of death over 100 times higher than that of normal birth weight infants (≥2,500 grams or 5.5 pounds). VLBW infants are significantly more likely to survive and thrive when born in a facility with a level-III Neonatal Intensive Care Unit (NICU), a subspecialty facility equipped to handle high-risk neonates. In 2012, the AAP provided updated guidelines on the definitions of neonatal levels of care to include Level I (basic care), Level II (specialty care), and Levels III and IV (subspecialty intensive care) based on the availability of appropriate personnel, physical space, equipment, and organization. Given overwhelming evidence of improved outcomes, the AAP recommends that VLBW and/or very preterm infants (<32 weeks’ gestation) be born in only level III or IV facilities.

Year: 2021

Unit Type: 100, Unit Number: Data Source: DPH Office of Women's Health- Neonatal Center Designation Program Data

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Adopt Standard Definitions for Hospital Level of Care" (https://www.mchevidence.org/tools/strategies/3-5.php). Find other NPM 3 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:

Goal: Update perinatal regionalization standards and designations and implement updated performance measures for hospitals in Majuro and Ebeye.

Numerator: Number Birthing Facilities Re-designated with standard operating procedures

Denominator: Total Number Birthing Facilities in the state

Significance: It is imperative for the RMI to ensure all hospitals are functioning in accordance with current standards of care for both maternal and infant outcomes.

Data Sources and Data Issues: Endorsed SOPs

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM is population-based (measures access to/receipt of care), thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

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

Service Type: Systems level of pyramid

Essential Public Health Services: 2. Investigate and address health problems

Service Recipient: Activities related to systems-building

Goal: Produce at least one yearly report describing the trends and activities surrounding VLBW births at Level I and Level II facilities.

Numerator: One report published from MCH Research and Planning in collaboration with Vital Statistics

Denominator: One report published from MCH Research and Planning in collaboration with Vital Statistics

Significance: This report will allow the MCH Bureau to share trends and issues in regard to VLBW births at Level I and Level II facilities for the purposes of public health intervention.

Data Sources and Data Issues: SC Perinatal Regionalization System

Year: 2021

Unit Type: Text, Unit Number: Yes/No

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 3 practice-level strategies in MCHbest.

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

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to professionals

Goal: By 2025, 75% of LHDs will use the NC-PAL in an effort to assist primary care providers in addressing the behavioral health needs of pregnant and post-partum patients.

Numerator: Number of LHDs who are utilizing the NC-PAL

Denominator: Number of LHDs providing maternal health services

Significance: Depression and anxiety during pregnancy and the postpartum period are common and have significant negative impacts on mother and child. Suicide is a leading cause of maternal mortality. Evidence-based efforts for screening, assessment, and treatment improve maternal and infant mental health, as well as overall family health, throughout the lives of women and children. NC-PAL or the NC Psychiatry Access Line, is a telephone consultation program designed to assist primary care providers in addressing the behavioral health needs of pediatric, pregnant, and post-partum patients. When primary care providers have a question about perinatal mental health, they can call the NC-PAL to be connected with the information they need. Care coordinators respond to questions within the scope of their expertise, provide resources and referrals, and can connect providers to psychiatric perinatal mental health specialists. Board-certified psychiatric perinatal mental health specialists can assist with diagnostic clarification and medication questions.

Data Sources and Data Issues: NC MATTERS Report

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Statewide Assessment of Personnel, Resources, and Capabilities of Birthing Facilities" (https://www.mchevidence.org/tools/strategies/3-6.php). Find other NPM 3 hospital-level strategies in MCHbest.

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: To accurately identify the neonatal and maternal level of care provided at the birthing hospitals in the RMI.

Numerator: Number of birthing hospitals who complete the CDC Levels of Care Assessment Tool (CDC LOCATe) annually

Denominator: Number of hospitals in the RMI

Significance: Ensuring infants are born at facilities that are equipped to meet the need of both the infant and the mother is important to improve both maternal and neonatal outcomes. The LOCATe tool is a hospital survey on obstetric and neonatal practices and services which classifies maternal and neonatal levels of care based on responses to survey questions.

Data Sources and Data Issues: MCH Program

Year: 2021

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Statewide Assessment of Personnel, Resources, and Capabilities of Birthing Facilities". Find other NPM 3 hospital-level strategies in MCHbest.

Measurement Quadrant: Quadrant 3: Measuring quantity of effect (# of "is anyone better off")

Service Type: Systems level of pyramid

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

Service Recipient: Activities related to systems-building

Goal: Implement the CDC's Level of Care Assessment Tool (LOCATe) Process in order to align and implement the national criteria for the Maternal Levels of Care

Numerator: Number of steps of the CDC's Level of Care Assessment Tool (LOCATe) Process completed

Denominator: Number of steps of the CDC's Level of Care Assessment Tool (LOCATe) Process completed

Significance: Creation of a system that aligns the maternal levels of care with Alabama Perinatal Regionalization System Guidelines utilizing CDC LOCATe ensures that there is a regionalized system for neonates and moms in our state. The CDC LOCATe tool is designed to help states and other jurisdictions monitor neonatal and maternal risk appropriate care. CDC LOCATe uses the minimum information necessary to identify a facility’s neonatal level of care, based on criteria by American Academy of Pediatrics, and maternal level of care based recently published criteria by the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine. According to the CDC, the steps of the CDC LOCATe Process are as follows: Step 1: BUILD SUPPORT FOR PARTICIPATION - An agency or organization serving as a state champion for CDC LOCATe identifies stakeholders to help encourage birth facilities to use the CDC LOCATe tool. The champion builds relationships with facilities to work toward statewide participation. Step 2: BEGIN USING TOOL TO COLLECT DATA - The champion sends the CDC LOCATe web link to facilities in the state and follows up with those that don't respond. Step 3: ANALYZE DATA AND SHARE RESULTS - The champion sends data to CDC to analyze. CDC assesses levels of maternal and neonatal care and sends back results that can be used and shared as desired.

Data Sources and Data Issues: Alabama Perinatal Regionalization System Data

Year: 2021

Unit Type: Count, Unit Number: 3

Measure Status: Active

Evidence Level: Emerging. Aligns with MCHbest strategy "Continuing Education of Hospital Providers" . Find other NPM 3 provider-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: 8. Build and support a workforce

Service Recipient: Activities directed to professionals

Goal: To encourage appropriate provider screening and counseling regarding substance use for positive impact.

Numerator: Number of prenatal providers trained

Denominator: All prenatal providers

Significance: Increasing effective communication regarding substance use among providers can lead to prevention and referral/treatment for misuse and abuse.

Data Sources and Data Issues: DHEC Programs, BOI

Year: 2021

Unit Type: Count, Unit Number: 123456

Measure Status: Active

Evidence Level: There is limited research in the evidence base for this NPM to support this strategy.

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 NM community health worker competencies in perinatal health

Numerator: Number of CHW, doulas or promotores de salud certified in perinatal health curricula

Denominator: Number of CHW, doulas or promotores de salud registered to practice in New Mexico

Significance: Increasing knowledge and competency, including traditional and community-based knowledge in perinatal health, is expected to support families in their informed decision making around prenatal and birthing support options.

Data Sources and Data Issues: NM Community Health Worker Association, NMDOH Office of Community Health Workers and the NM Doula Association

Year: 2021

Unit Type: Count, Unit Number: 100

Measure Status: Active

Evidence Level: There is limited research in the evidence base for this NPM to support this strategy.

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

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: To provide parents of newborn babies a passbook to monitor baby milestones, development, immunizations and clinic schedule.

Numerator: Number of newborns issued a newborn baby health passbook annually

Denominator: Number of births in the RMI per year

Significance: Ensure newborns are equipped with a tool to monitor their growth, development, immunization and clinic schedule.

Data Sources and Data Issues: MCH Program, Marshall Hospital Information System

Year: 2021

Unit Type: Percentage, Unit Number: 100