Maternity Care Moving from Vision to Action through the TMC Partnership!
Plus:Another maternity care quality bill filed in Congress | New resources for advocacy | Louisiana launches birth outcomes project | Leading employers launch bold payment reform initiative | Better ways to pay for maternity care | Reconsidering the costs of convenience | Ohio reduces scheduled births before 39 weeks
We're thrilled to bring you the first edition of the Transforming Maternity Care Partnership e-News. Together with a diverse group of TMC Partners, we're making progress toward our shared vision of a high-quality, high-value maternity care system, using the Blueprint for Action as our roadmap. This monthly e-News will share news from the field, like the statewide effort in Louisiana to improve birth outcomes modeled on the TMC Project. We'll also highlight opportunities for each of you to be part of the maternity care transformation, like supporting new legislation focused on maternity care quality and payment reform. Finally, we'll continue to bring you quality improvement research along with other features.
The new look and focus of our e-News is not the only change at Childbirth Connection. After four years of exemplary work planning and executing our 90th Anniversary Symposium and coordinating the development of the Vision statement, Blueprint for Action, and workgroup and other Symposium reports, Rima Jolivet has taken a job with the White Ribbon Alliance for Safe Motherhood, where she will use her skills and insights to improve global maternal health. We're very excited to welcome Amy Romano, MSN, CNM, as our new Associate Director of Programs. Amy brings expertise in clinical practice, research, and social media to Childbirth Connection. You can read Amy's bio to learn more, or email her at firstname.lastname@example.org to introduce yourself.
Take Action: Help Transform Maternity Care
New maternity care quality bill filed in congress
Late last month, Congressman Elliot Engel (D-NY) and Congresswoman Sue Myrick (R-NC) filed the Partnering to Improve Maternity Care Quality Act of 2010 (HR 6437). Childbirth Connection was honored to work with the offices of Mr. Engel and Mrs. Myrick on this significant bipartisan legislation.
This act addresses many of the recommendations put forth in the direction-setting Blueprint for Action, with provisions related to many of the Blueprint's 11 focal areas, including performance measurement and leveraging of results; payment reform aligning incentives with quality; scope of covered services for maternity care; coordination of maternity care across time, settings, and disciplines; decision-making and consumer choice; and development and use of health information technology.
eNews readers are encouraged to:
Two new factsheets available from Childbirth Connection
Maternity care is a major and costly segment of our health care system and deserves focused attention from all stakeholders. Two newly updated resources from Childbirth Connection provide a concise but compelling glimpse of the outcomes and costs of maternity care in the United States. Updated with the latest federal statistics, United States Maternity Care Facts and Figures and Facility Labor and Birth Charges by Site and Mode of Birth can help members of the TMC Partnership community make the case for system transformation. Take action and share these important resources via email or social networks like Facebook and Twitter, or download them as printer-friendly PDFs to distribute among your colleagues.
Good News from the Field: Partners Putting the Blueprint into Action
The State of Louisiana Birth Outcomes Project
This exciting project has been established by the Governor's Office and the Louisiana Department of Health and Hospitals in partnership with the Louisiana Commission on Perinatal Care. Its objective is to develop and implement a statewide action plan to improve birth outcomes at state and system levels. This multi-stakeholder initiative draws inspiration from the Transforming Maternity Care project, and has charged several interdisciplinary task forces with constituencies modeled after the five TMC stakeholder workgroups to determine critical next steps for progress in five major areas: data and performance measurement; care coordination and pre-and inter-conception care across time, settings and disciplines; patient safety and quality of care; health disparities in birth outcomes; and behavioral health.
I am very pleased to serve as a member of the Blue Ribbon Panel of the Louisiana Birth Outcomes Project, and congratulate Louisiana Birth Outcomes Project Director Rebekah Gee, MD, MPH, FACOG, for her outstanding leadership and commitment to bringing public and private partners together to address health system issues that negatively impact the health of women and newborns in Louisiana. Dr. Gee will join us for a "TMC Topics" webinar on April 12, 2010, to update us on this exciting work.
Leading employers launch bold payment reform initiative
TMC Vision Team and Partnership Steering Committee member Suzanne Delbanco, PhD, has been named Executive Director of Catalyst for Payment Reform, a collaboration among seven of the nation's largest employers using their purchasing power to advocate for health care payment approaches that reduce costs and waste while spurring higher quality. CPR has created a national framework and toolkit to increase coordination of payment reform efforts and disseminate best practices so that they can be broadly implemented. Accounting for one in four hospital discharges, maternity care is the costliest hospital condition billed to private insurers, and represents a critical area on which to focus payment reform efforts.
Consider This: Resources to Expand Your Vision for Improvement
Better ways to pay for maternity care: Webinar will explore how payment reform can improve quality and reduce costs
Can we have our cake and eat it too? Can insurers and individuals pay less for maternity care without reducing quality or revenues for hospitals and care providers? The TMC Topics webinar series continues Tuesday, December 14, at 12:00pm EST with an exploration of these questions featuring national payment reform expert Harold D. Miller, President and CEO of the Network for Regional Healthcare Improvement, and Executive Director of the Center for Healthcare Quality and Payment Reform. Based on Miller's work, including the landmark report From Volume to Value, the webinar will feature the most promising models for payment reform to align incentives with maternity care quality and highlight demonstration projects where payment reforms are underway. Register for the free webinar today.
Reconsideration of the costs of convenience: Quality, operational, and fiscal strategies to minimize elective labor induction, by Kathleen Rice Simpson
Journal of Perinatal & Neonatal Nursing. 2010, Volume 24, Number 1, pages 43-52 (abstract)
This excellent article reviews the current evidence related to outcomes of elective labor induction, calling for focused attention on the increased risk of primary cesarean delivery in first-time mothers who undergo labor induction without a medical reason before 41 weeks gestation with an unripe cervix, in addition to the heightened risk of iatrogenic prematurity and morbidity of the newborn, and the adverse effect of uterine hyper-stimulation related to administration of oxytocin, a high-alert medication – two common harms of elective induction.
The article also offers concrete, detailed suggestions for strategies to reduce this intervention at different levels of the maternity care system and by addressing various drivers of the practice. There are strategies aimed at childbearing women and families, at frontline providers, at health care delivery organizations, and finally at the macro level of the maternity care system. This is essential reading for anyone interested in Transforming Maternity Care, and one we feel sure will expand your vision for improvement and open a long clear sightline to maternity care improvement in your setting!
Cause for Optimism: Maternity Care Moving in the Right Direction
A statewide initiative in Ohio reduces scheduled births before 39 weeks with no documented medical indication
American Journal of Obstetrics & Gynecology. 2010, Volume 202(3), pages 243.e1-8 (abstract)
A quality collaborative consisting of twenty hospitals in the state of Ohio representing 47% of all births in the state came together to reduce the number of scheduled births occurring before 39 weeks gestation without an appropriate documented medical indication. Interdisciplinary teams from each hospital championed the initiative in their sites, and participated in regular meetings and learning sessions. Key drivers for change were agreed upon, drawing upon research evidence, ACOG clinical guidelines, and other successful projects reported in the literature, and the teams used improvement techniques derived from the Institute for Healthcare Improvement Breakthrough Series.
The collaborative reported that the rate of scheduled births taking place between 36 and 39 weeks gestation decreased significantly from 25% to <5% in participating hospitals in one year. Birth certificate data in the corresponding period showed a significant decrease in the mean rate of inductions with no indication from 13% to 8%. While some degree of uncertainty remains about what proportion of these results may be attributable to changes in providers' documentation of the reasons for inducing labor, this quality improvement project provides clear evidence of maternity care moving in the right direction.
Together with similar quality improvement projects in other regions, this effort may have contributed to the documented decrease in the national preterm birth rate reported last month. Childbirth Connection reviews the new preterm birth data along with other maternity care outcomes, trends, and costs on our updated Maternity Care Facts and Figures page.
Most recent page update: 3/8/2011
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Founded in 1918, Childbirth Connection has joined forces with and become a core program of the National Partnership for Women & Families. Together, these two women's health powerhouses are transforming maternity care in the United States.
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