CP30 - Addressing the Maternal Mortality Crisis in the Ambulatory Setting: A Quality Improvement Approach
Poster Type: Research
Track/Topic: Patient and Community Engagement; Public Health Crises; Quality of Care and Quality Improvement
Research Objectives: The Chicago Collaborative for Maternal Health, led by AllianceChicago and EverThrive Illinois, aims to improve maternal health via quality improvement in ambulatory care, community engagement, and policy advocacy. AllianceChicago is leading QI, a population health model seeking to increase the percentage of high-risk patients linked to primary care after delivery.
Research Study Design/Methods: The CCMH QI collaborative reflects the Institute for Healthcare Improvement’s (IHI) “Collaborative Model for Achieving Breakthrough Improvement,” which includes the following activities: topic selection; expert recruitment; participating organization recruitment; action periods; and learning sessions. AllianceChicago will conduct pre- and post- comparison of the quality improvement intervention: de-identified, aggregate baseline data collection to compare with deidentified, aggregate post-intervention data collection along with analysis of a small subset of patient level, de-identified data from AllianceChicago participating sites. Each clinic will pilot the intervention with their own designated high-risk criteria based on their patient population.
Research Principal Findings and Quantitative/Qualitative Results: AllianceChicago engaged thirteen partners to inform QI, with seven implementing. We conducted baseline data collection on structure, process, and outcome measures. Structure and process measures include: high-risk criteria defined/implemented; care coordination process identified/implemented; number of staff trained; and number of locations of care implemented. At baseline, three sites had existing high-risk criteria and care coordination processes; no sites had processes linking to primary care. All sites are implementing in at least one location of care with staff trainings in process. The primary outcome measure is the percentage of high-risk patients connected to primary care. The aggregate baseline was 26 percent.
Research Conclusions on Impact on Health Centers: According to the Chicago Department of Public Health’s report, “Maternal Morbidity and Mortality in Chicago,” non-Hispanic Black birthing people have the highest rates of maternal morbidity and mortality in Chicago. This is reflective of data at state/national levels. The baseline data is clear there are opportunities for improvement in linking high-risk prenatal patients to primary care after delivery, a crucial time to impact outcomes. From initial learnings, AllianceChicago has developed an algorithm to define and identify high-risk patients to coordinate care, which supports health center capacity and aims for this pilot to be sustainable, replicable, and scalable.
Jena Wallander Gemkow, MPH, BSN, RN, Clinical Research Manager, AllianceChicago