Implementation of perinatal quality collaborative statewide initiative improves obstetrical opioid use disorder care and outcomes.

Background: Maternal deaths resulting from opioid use disorder have been increasing across the United States. Opioid use disorder among pregnant persons is associated with adverse pregnancy outcomes, including preterm birth, along with racial disparities in optimal opioid use disorder care.

Objective: This study aimed to evaluate whether the Illinois Perinatal Quality Collaborative implementation of the Mothers and Newborns affected by Opioids - Obstetric quality improvement initiative was associated with improvement in opioid use disorder identification, provision of optimal opioid use disorder care for birthing patients, and reduction in racial gaps in optimal opioid use disorder care.

A Mixed Methods Evaluation of a Quality Improvement Model to Optimize Perinatal and Primary Care in the Community Health Setting.

Purpose: Many maternal deaths occur beyond the acute birth encounter. There are opportunities for improving maternal health outcomes through facilitated quality improvement efforts in community settings, particularly in the postpartum period. We used a mixed methods approach to evaluate a collaborative quality improvement (QI) model in 6 Chicago Federally Qualified Health Centers (FQHCs) that implemented workflows optimizing care continuity in the extended postpartum period for high-risk prenatal patients.

Optimizing accuracy of birth certificate data through a statewide quality improvement initiative in Illinois.

Objective: This study examines improvement in birth certificate accuracy during a statewide quality improvement initiative.

Study Design: Participating hospitals systematically sampled 10 delivery medical records per month and compared them to corresponding birth certificates for accuracy. Accuracy was computed before implementing the initiative (Aug-Oct 2014), end of phase 1 (July 2015) and end of phase 2 (Nov-Dec 2015).

Improving the Timely Delivery of Antihypertensive Medication for Severe Perinatal Hypertension in Pregnancy and Postpartum.

Objective: Sustained blood pressures ≥160/110 during pregnancy and the postpartum period require timely antihypertensive therapy. Hospital-level experiences outlining the efforts to improve timely delivery of care within 60 minutes have not been described. The objective of this analysis was to assess changes in care practices of an inpatient obstetrical health care team following the implementation of a quality improvement initiative for severe perinatal hypertension during pregnancy and the postpartum period.

Advances in Maternal Fetal Medicine: Perinatal Quality Collaboratives Working Together to Improve Maternal Outcomes.

State-based perinatal quality collaboratives (PQCs) address preventable causes of maternal and infant morbidity and mortality by implementing statewide quality improvement (QI) initiatives. They work with hospital clinical teams, obstetric provider and nursing leaders, patients and families, public health officials, and other stakeholders to provide opportunities for collaborative learning, rapid-response data, and QI science support to achieve clinical culture change. PQCs show that the application of collaborative improvement science methods to advance evidence-informed clinical practices using QI strategies contributes to improved perinatal outcomes.

A Framework to Harness the Power of Quality Collaboratives to Improve Perinatal Outcomes.

The Illinois Perinatal Quality Collaborative developed a framework for successfully engaging teams and implementing statewide obstetric and neonatal quality improvement (QI) initiatives. This framework includes: (1) engaging hospitals to create an environment of improvement; (2) motivating hospital teams to facilitate change at their hospital; and (3) supporting hospital teams through the 3 pillars of QI-collaborative learning opportunities, rapid-response data, and QI support-to achieve initiative goals and improve outcomes for mothers and newborns. Utilizing this framework, the Illinois Perinatal Quality Collaborative Severe Maternal Hypertension Initiative engaged teams and achieved initiative goals.

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.

Quality improvement efforts are an increasingly expanding focus for perinatal care providers across the United States. From successful hospital-level initiatives, there has been a growing effort to use and implement quality improvement work in substantive and meaningful ways. This article summarizes the foundations of maternal-focused, birth-focused, and neonatal-focused quality improvement initiatives to highlight the underpinnings and potential future directions of current state-level perinatal quality care collaboratives.

Role of patient treatment beliefs and provider characteristics in establishing patient-provider relationships.

Background: Positive patient-provider relationships have been associated with improved depression treatment outcomes. Little is known about how patient treatment beliefs influence patient-provider relationships, specifically treatment alliance and shared decision making in primary care (PC).

Objective: We evaluated the relationship between patient treatment beliefs and patient-provider relationships by gender, race and current depression.

Cultural differences in perinatal experiences for women with low socioeconomic status.

In this study, similarities and differences in perinatal experiences between women with low socioeconomic status (SES) by race, ethnicity, and nativity were explored. The objective was to better understand the sociocultural and environmental contexts ofperinatal experiences and potential implications for screening and assessment among women with low SES. A purposive stratified sample of 32 women who were likely to be screened for perinatal depression participated in four focus groups organized by African American, white, Hmong, or Latina race or ethnicity.

Clinical needs of in-treatment pregnant women with co-occurring disorders: implications for primary care.

We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States.

Perinatal HIV testing among African American, Caucasian, Hmong and Latina women: exploring the role of health-care services, information sources and perceptions of HIV/AIDS.

Perinatal HIV transmission disproportionately affects African American, Latina and potentially Hmong women in the United States. Understanding racially and ethnically diverse women's perceptions of and experiences with perinatal health care, HIV testing and HIV/AIDS may inform effective health communications to reduce the risk of perinatal HIV transmission among disproportionate risk groups. We used a qualitative descriptive research design with content analysis of five focus groups of African American, Caucasian, Hmong and Latina women of reproductive age with low socioeconomic status distinguished by their race/ethnicity or HIV status.

Replicability of structural models of the Edinburgh Postnatal Depression Scale (EPDS) in a community sample of postpartum African American women with low socioeconomic status.

The Edinburgh Postnatal Depression Scale (EPDS) is increasingly used in public health and social service programs serving postpartum women of racially, ethnically, and socioeconomically diverse backgrounds at risk for depression. However, we know little about its factor structure across groups of women with implications for measuring symptom levels in research. This study evaluated the underlying structure of the EPDS using a confirmatory factor analyses model comparison approach of five factor models from the literature in a purposive community sample of 169 postpartum African American women of low socioeconomic status.