Maternity Care Moving from Vision to Action through the TMC Partnership!
In this issue: Federal grant applications for home visitation program due July 1 | MOMS-21 reintroduced in Congress | New data about childbirth-related PTSD | AHRQ offers maternity care webinar | Geisinger ProvenCare shows promising results for moms and babies
For every quality improvement program, like Geisinger ProvenCare Perinatal, that appears in a peer-reviewed journal, there are many more that are celebrated only locally. We see this as a missed opportunity. Sharing lessons learned from these projects makes it easier for the next person wanting to make change. That's why we launched the Transforming Maternity Care Directory, where you can add your projects and others can search by Blueprint area or quality improvement strategy. Whether it's a state-wide data collection project in Washington, a grassroots consumer Birth Network in New York, or a hospital-based family bonding program in Florida, chances are someone else would like to implement something similar. The Transforming Maternity Care Directory is a place to get inspired, get connected, and get started making change.
Take Action: Help Transform Maternity Care
Federal grants available to ramp up maternal and child home visiting programs
Just one of the many provisions of the Affordable Care Act for childbearing women and newborns was a large-scale expansion of funding for maternal and child health home visitation programs. A round of grant funding has just been announced to help states providing home visitation to expand and enhance these programs. States receiving grants will use the funds to either enhance one or more elements of a state-wide home visiting program or scale up a local program to cover the entire state. Applications are due July 1. More information and the grant application materials are available from Grants.gov.
Good News from the Field: Partners Putting the Blueprint into Action
MOMS for the 21st Century Bill Reintroduced in the 2011 Congress
The Maximizing Optimal Maternity Services for the 21st Century Act (HR 2141), sponsored by Congresswoman Lucille Roybal-Allard of California, places a national focus on maternity care practices by establishing an Interagency Coordinating Committee responsible for promoting the best evidence-based maternity practices across all federal programs. The legislation also authorizes a media campaign to educate consumers about how to achieve the healthiest outcomes for mothers and babies, expands federal research on best maternity practices, and authorizes data collection to identify areas with maternity care workforce shortages. Read the full text of HR 2141 at Open Congress.
Consider This: Resources to Expand Your Vision for Improvement
Nearly one in five women have post-traumatic stress symptoms after giving birth
Using data from Childbirth Connection's national Listening to Mothers II Survey and New Mothers Speak Out report, researchers determined that 18 percent of women scored above the cutoff score on a standard posttraumatic stress disorder (PTSD) screening tool, which indicated that they were experiencing elevated levels of posttraumatic stress symptoms. Nine percent screened positive for meeting all of the criteria for childbirth-related PTSD. Posttraumatic stress levels were higher in women with low partner support, elevated postpartum depressive symptoms, more physical problems since birth, and less health-promoting behaviors. In addition, women with elevated posttraumatic stress symptoms were more likely than those who did not to have had no private health insurance, unplanned pregnancy, pressure to have an induction and epidural analgesia, and planned cesarean birth. Women with elevated posttraumatic stress were more likely not to breastfeed as long as they had wanted, to not be exclusively breastfeeding at 1 month, and to consult with a clinician about mental well-being after giving birth. The study, co-authored by Childbirth Connection's Carol Sakala, was published online in the journal Birth: Issues in Perinatal Care.
AHRQ Zooms In On Maternity Care
The Agency for Healthcare Research and Quality recently hosted a free webinar focusing on performance measurement, public reporting, and strategies for maternity care quality improvement. Childbirth Connection's Maureen Corry, gave an overview of the 2020 Vision and Blueprint for Action, discussed poor national performance on widely recognized maternal and newborn indicators, and reviewed Blueprint recommendations for performance measurement and leveraging results to improve maternity care quality and value. Michael Lundberg from Virginia Health Information, the only state site providing access to facility- and provider-level quality data, discussed efforts to educate consumers about maternity care quality. Dennis English, MD from Magee Women’s Hospital of UPMC in Pittsburgh discussed a successful effort to dramatically reduce pre-term elective inductions and c-sections.
Cause for Optimism: Maternity Care Moving in the Right Direction
Geisinger ProvenCare uses evidence-based guidelines and Health IT to drive measurable quality improvement
In 2007, Geisinger Health Systems adapted its renowned ProvenCare quality improvement approach to maternity care. A new paper published in the Joint Commission Journal of Quality and Patient Safety reports on the implementation and preliminary results of ProvenCare Perinatal. Implemented in 22 practice sites and 4 hospitals, the program involved a robust review of the medical literature to identify evidence-based elements of care, a survey of care processes and work flows, and development of health information technology systems to ensure that all women and babies received each evidence-based element of care at the appropriate time during pregnancy, labor, birth, and the postpartum/newborn period. The program also integrated the augmentation and induction bundles from the Institute for Healthcare Improvement's Perinatal Improvement Community. Significant improvement occurred for nearly all of the 103 best practice measures identified, indicating that care process improved to be aligned with best evidence. Notably, 100% of new mothers have been screened for postpartum depression since late 2009. In addition, at one of the two referral hospitals, the primary cesarean section rate decreased 32% (from 30.3% to 23.8%). At the other, the rate remained the same. There was no increase in birth trauma. Neonatal intensive care admissions decreased both overall and among the subgroup of babies born to women with insulin-dependent gestational diabetes. Learn more about this project.