Article describing the creation of the PNQIN Equity Bundle Measures.

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Referenced in 9/27 Equity Webinar.

Meet the Irving Family. Wanda’s daughter and Soleil’s mother, Shalon – like hundreds of U.S. women each year – died due to a pregnancy related complication. The Irving Family’s Story is part of the Voices of Impact video series out of the Council on Patient Safety in Women’s Health Care to elevate the experiences of women and families. The series is designed to encourage the adoption of standardized best practices to improve quality and drive culture change in order to reduce preventable maternal mortality and morbidity.

Referenced in 9/27 Equity Webinar.

Key Findings:

Among pregnancy-related deaths with information on timing, 22% of deaths occurred during pregnancy, 25% occurred on the day of delivery or within 7 days after, and 53% occurred between 7 days to 1 year after pregnancy.

The leading underlying causes of pregnancy-related death include:

  • Mental health conditions (including deaths to suicide and overdose/poisoning related to substance use disorder) (23%)
  • Excessive bleeding (hemorrhage) (14%)
  • Cardiac and coronary conditions (relating to the heart) (13%)
  • Infection (9%)
  • Thrombotic embolism (a type of blood clot) (9%)
  • Cardiomyopathy (a disease of the heart muscle) (9%)
  • Hypertensive disorders of pregnancy (relating to high blood pressure) (7%)

The leading underlying cause of death varied by race and ethnicity. Cardiac and coronary conditions were the leading underlying cause of pregnancy-related deaths among non-Hispanic Black people, mental health conditions were the leading underlying cause for Hispanic and non-Hispanic White people, and hemorrhage was the leading underlying cause for non-Hispanic Asian people.

Non-PNQIN Toolkit

Policy Points:

  • There need to be sweeping changes to medical school curricula that addresses structural racism in medicine and how to attend to this in medical practice.
  • The Liaison Committee on Medical Education should develop and promulgate specific learning objectives and curricular offerings that require medical schools to teach about structural racism and antiracist medical practice in ways that are robust and standardized.
  • The federal government, through the Health Resources and Services Administration, should prioritize support for antiracism education in medical schools, residency, and continuing medical education in similar ways and with similar effort in scale and scope to its support for primary care, providing technical assistance and grants for programs across the educational spectrum that provide antiracist training.
  • State governments should mandate, as part of continuing education requirements for physicians, 2 or more hours per recertification cycle of antiracist training.

Quality Improvement Framework

We teamed up to create a PREM that allows birthing facilities to assess patients’ experience in receiving respectful care during their birthing experience these are are based on the respectful care guidelines from ILPQC and NYSPQC