ONGOING COLUMNS: Commentary
There is an old saying that “together we can do great things.” Although individuals can make a significant difference, working with a multidisciplinary team in a variety of clinical settings in many states has the potential to raise the impact of these collective efforts exponentially. This premise is the foundation of the National Network of Perinatal Quality Collaboratives sponsored by the Centers for Disease Control and Prevention (CDC) with the National Institute for Children's Health Quality acting as the coordinating center. The program was initiated in 2016 by the CDC and the March of Dimes Foundation. The main goal is to assist statewide perinatal quality collaboratives in their work to improve care and outcomes for mothers and babies. Many states have perinatal quality collaboratives, although there are a variety of organizational structures, clinical goals, funding, and leadership teams. Some have been developed at the hospital or health system level, whereas others have been organized by regional or state-based organizations such as state departments of health, state hospital associations, regional perinatal centers, and professional associations (Schneider, Sabol, Lee King, Caughey, & Borders, 2017). A complete list can be found at https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pqc-states.html. Some of the state collaboratives are being funded by the CDC such as Colorado, Delaware, Florida, Georgia, Illinois, Louisiana, Massachusetts, Minnesota, Mississippi, New Jersey, New York, Oregon, and Wisconsin.
Perinatal quality collaboratives have already produced excellent results including a decrease in healthcare-associated bloodstream infections in newborn babies (Gupta, Donovan, & Henderson, 2017), fewer elective births before 39 completed weeks of gestation (Kacica, Glantz, Xiong, Shields, & Cherouny, 2017), and a decline in severe pregnancy complications (Main et al., 2017). Success stories have been shared by individual states so others can see what is possible when working together. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pqc.htm
Success in part is due to the team approach. These efforts are not led by individual physicians, nurses, or hospital administrators, rather they are initiated by clinicians, researchers, and public health experts with a stake in perinatal outcomes such as midwives, perinatal and neonatal nurses, obstetricians, maternal–fetal medicine specialists, neonatologists, pediatricians, and family medicine physicians. New mothers are an essential part of the group and their voices are highly valued.
Current projects in CDC-funded state collaboratives include programs to reduce preterm birth; severe pregnancy complications associated with high blood pressure and hemorrhage; racial, ethnic, and geographic disparities; and cesarean birth for low-risk women, and improve care for babies with neonatal abstinence syndrome. The CDC offers supportive materials for states planning to initiate a perinatal quality collaborative such as a Developing and Sustaining Perinatal Quality Collaboratives: A Resource Guide for States https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pdf/Best-Practices-for-Developing-and-Sustaining-Perinatal-Quality-Collaboratives_tagged508.pdf, webinars, monthly public health grand rounds, annual in-person meetings, and various publications.
If there is a perinatal quality collaborative in your state and your hospital or healthcare system is not a part of the group, encourage the clinicians and leadership team to join. If your hospital is involved, take an active role and invite others to do the same. Mothers and babies benefit when everyone is working together to improve perinatal care and outcomes.
Gupta M., Donovan E. F., Henderson Z. (2017). State-based perinatal quality collaboratives: Pursuing improvements in perinatal health outcomes for all mothers and newborns. Seminars in Perinatology
, 41(3), 195–203. doi:10.1053/j.semperi.2017.03.009
Kacica M. A., Glantz J. C., Xiong K., Shields E. P., Cherouny P. H. (2017). A statewide quality improvement initiative to reduce non-medically indicated scheduled deliveries. Maternal and Child Health Journal
, 21(4), 932–941. doi:10.1007/s10995-016-2196-5
Main E. K., Cape V., Abreo A., Vasher J., Woods A., Carpenter A., Gould J. B. (2017). Reduction of severe maternal morbidity from hemorrhage using a state perinatal quality collaborative. American Journal of Obstetrics and Gynecology
, 216(3), 298.e1–298.e11. doi:10.1016/j.ajog.2017.01.017
Schneider P. D, Sabol B. A., Lee King P. A., Caughey A. B., Borders A. E. B. (2017). The hard work of improving outcomes for mothers and babies: Obstetric and perinatal quality improvement initiatives make a difference at the hospital, state, and national levels. Clinics in Perinatology
, 44(3), 511–528. doi:10.1016/j.clp.2017.05.007