March of Dimes39+ Weeks Quality

Improvement Service Package

2012

Elimination of Non-medically Indicated Deliveries Before 39 Weeks Toolkit

Available at: marchofdimes.c

omor

cmqcc.org

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QI Service Package 

Hospital Recognition* 

*For those hospitals that achieve clear QI implementation process points

•Grand Rounds•Secure Web Based Data Portal•Webinars•Materials Credit•Access to “Experts in the Field”

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QI Service PackageGrand Rounds

• A National Speakers Bureau in partnership with ACOG and AWHONN members to support hospital Grand Rounds

• Trained experts in perinatal care and quality improvement 

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Secure Web Based Data Portal

Data Portal Goals

1. To help each hospital monitor its own program effectiveness

2. To measure initiative’s overall effectiveness across hospitals

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Secure Web Based Data Portal

Data Portal Reports– Monthly and quarterly reports

detailing key indicators and outlining change from previous months both in tabular and graphic form

– Reports will include hospital data and comparisons to aggregate data from other hospitals (without hospital identifiers).

– Key indicators include the number and percent of early term (37 0/7 – 38 6/7) scheduled inductions and cesarean section deliveries that are non-medically indicated (elective).

Sample ReportSample Hospital (SH)

Hospital Cohort 11 Cohort 2

Scheduled Deliveries

Scheduled Inductions

Elective Scheduled Inductions

Measure 3: Percent of scheduled inductions that are elective

Scheduled Cesarean Deliveries

Elective Scheduled Cesareans

Measure 4: Percent of scheduled cesareans that are elective

Total Scheduled Deliveries (Inductions and Cesareans)

Elective Scheduled Deliveries

Measure 5: Percent of all scheduled deliveries that are elective

Total Deliveries (scheduled and unscheduled)

Measure 6: Percent of all deliveries that are elective

NICU Admissions after a Scheduled Elective Delivery

Measure 7: Percent of infants admitted to the NICU / special care nursery after a scheduled elective delivery

1 Cohorts will be defined to determine meaningful benchmarks.

Prepared by the March of Dimes Perinatal Data Center, 2011An elective delivery is non-medically indicated.

Singleton Early Term Deliveries (37 0/7 through 38 6/7 weeks gestation)

January, 2012

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QI Service Package (Cont’d)

 Webinars• Presented by content leaders from across the country.

• Step-by-step toolkit implementation guidance will be provided via six 30-60 minute archived Webinars entitled: – Overview of the <39 Weeks Problem and Toolkit Change

Components– Outline Medical and Non-Medical Indications <39 Weeks– Data Collection – Baseline and Post Implementation– Establishing Physician & Nursing Leadership and a

Medical Hard Stop– Building Consensus – Difficult Provider Q&A– Patient Education

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QI Service Package (Cont’d)

March of Dimes educational materials for consumers/patients to support implementation, including: “Why the Last Weeks of Pregnancy Count” brochures, brain card flyer, and posters

 

• Late preterm brain development flyer – consumer.

• Late preterm brain development card- - provider.

• “Why the last weeks of pregnancy count” brochure –consumer.

• Late preterm brain development poster.

• Poster of pregnant woman wearing “Healthy Babies are Worth the Wait”

t- shirt image and message identical to print ad.

Sample Materials

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QI Service Package (Cont’d)

 Access to “Experts in the Field”• Access to a listserv that includes experts as well as

providers and other hospitals participating in March of Dimes-supported QI initiatives (e.g., to ask questions, seek advice, share lessons learned, etc.)

• Monthly “office hours”, which are live chats with national QI experts and providers (e.g., to ask questions, etc.)

• Experts available on a rotational basis include:– Bryan Oshiro, MD– Donald Dudley, MD– Kathleen Rice Simpson, PhD, RNC, FAAN

 

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Hospital Recognition

 Hospital QI Recognition as “participating in a March of Dimes 39+ Weeks Quality Improvement Initiative…” that includes:

 

– March of Dimes plaque and banner for hospital

– Listing on March of Dimes website (www.prematurityprevention.org)

– Opportunity for co-branding on media campaign!

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Questions?

Contact Lori Reeves @ March of Dimes321-274-8674lreeves@marchofdimes.com