Improvements To Date Among Participating Hospitals
2-day reduction in average length of hospital stay for substance-exposed newborns.
Nearly 40% reduction in need for pharmacologic therapy for Neonatal Abstinence Syndrome (NAS).
12% sustained improvement in rates of skin-to-skin contact within the first 24 hours of infant life.
Over 60% reduction in NICU infections.
23% reduction in need for intensive care for infants.
24% increase in the proportion of birthing people with measurement of blood loss from birth through recovery using quantitative blood loss (QBL)/cumulative blood loss (CBL).
50% reduction in early elective deliveries as a result of MPQC, March of Dimes, and ACOG’s initiation of the hard-stop policy for elective deliveries prior to 39 weeks (2010-2013).
As a result of MPQC’s formal QI training and dissemination of hemorrhage best practices, deliveries with transfusion decreased from 1.6% to 0.5% and deliveries with ICU admission decreased from 0.5% to 0.0% (2013-2016).
Engagement
33 out of 40 birthing hospitals in the state engaged in AIM patient safety bundle activities in 2022.
40 out of 47 hospitals in the state participated over the course of the Perinatal Opioid Project (2017-2022).
10 out of 10 Level III NICUs joined projects to reduce NICU infections, improve Safe Sleep practices for high-risk infants, and increase support for NICU mothers to provide breast milk.
All 40 birthing hospitals in the state completed the CDC Levels of Maternal Care Assessment Tool (LOCATe) in 2021.
PNQIN advisors and volunteers attended 43 community COVID-19 vaccination events in 13 communities in 2021-2022 to provide educational resources and support.
Approximately 400 attendees from across the state participated in biannualPerinatal Opioid Project summits between 2017 and 2022.
Trainings
Approximately 500 nurses, providers, and perinatal staff trained in SPEAK UP Implicit and Explicit Racial Bias Education since 2020.
560 providers across the state have taken PNQIN’s Stigma, Bias, and Trauma-Informed Care (SBTIC) training since 2020.
Over 1,000 staff from 20 unique hospitals and organizations have been trained since 2019 in the Massachusetts Screening, Brief Intervention and Referral to Treatment (MASBIRT) framework.
50 obstetric providers participated in buprenorphine waiver training.
172 providers and community health workers in 19 (out of 20) communities that were hardest hit by COVID-19 were trained from 2021-2022 in motivational interviewing skills to address vaccine hesitancy.
Response
Partnership with the Betsy Lehman Center for Patient Safety (BLC) to distribute individualized reports on Severe Maternal Morbidity (SMM) data to all 40 MA birthing hospitals.
Dedicated assistance for hospital teams to organize and act to decrease maternal morbidity and mortality via QI initiatives and evidence-based practices.
Implementation of tools to care for pregnant people experiencing substance use disorder (SUD).
Support for hospital quality improvement teams to reduce morbidity from obstetric hemorrhage and severe hypertension.
Development of structure and process measures based on equity best practices to help teams establish cultures of equity in their OB departments.
Encourage data stratification by age, race, ethnicity, sex, gender/gender identity, payor, disability status, employment status, and preferred language when possible.
Application of CDC Levels of Maternal Care guidelines to ensure pregnant people receive risk-appropriate care.
Engagement of nurses and perinatal professionals across the state in anti-racist care practices through continued SPEAK UP Implicit and Explicit Racial Bias Education.
Provision of accurate, up-to-date guidance and resources on counseling and administration of the COVID-19 vaccine to pregnant and lactating people in Massachusetts.
Dedicated space on our website for COVID-19 resources, decision aids, official comments, and practice advisories from our partner hospitals and organizations.
Hosted 13 town halls (approx. 100 attendees each) with hospital and state partners focusing on maternal and neonatal COVID-19 response in the state and to elevate experiences of birthing people:
Safe family care in-hospital
Management of outpatient services for all patients
Care and discharge of infants born to parents with COVID-19
Findings from Massachusetts hospital perinatal COVID-19 practice surveys and individual health outcomes
Social disparities in perinatal COVID-19
Ongoing efforts to improve care of birthing people and families during the pandemic
Evolving COVID-19 science and recommendations
Supported a core database of process and outcome measures related to the hospital-based care of over 4,000 dyads of mothers with OUD and newborns at risk for NAS.
Development of an equity dashboard for the core database in order to stratify key measures by race and ethnicity and tracking performance over time.
Executed two, year-long monthly webinar series to support and educate teams implementing the AIM patient safety bundle focused on SUD in pregnancy.
Hosted twice-year Perinatal Opioid Project summits that brought together a broad and diverse community committed to the common goal of improving care of families impacted by perinatal opioid use.
Launch of pioneering public health NAS dashboard.
Development of Eat-Sleep-Console non-pharmacologic care training program, which has attracted national attention.
Creation of staff attitude and knowledge survey of perinatal opioid use.
Data linkage project connecting hospital discharge with Early Intervention enrollment.
Launch of Project INSPiRE (Inviting Narratives of SUD treatment in the Perinatal period: a focus on Race and Equity) targeted community-based participatory research with peer-led interviews of parents of color with substance use disorder.
Piloted a state-supported project for hospitals to engage families with lived experience in their local quality improvement efforts related to perinatal opioid use.
Engagement with three teams of Boston University School of Public Health consulting students to address questions and provide recommendations for addressing stigma, bias, and racism in SUD care and sustainment of PNQIN POP.
Leveraged and strengthened partnerships between PNQIN and multiple state and community organizations.
