STEP 1: The DCPQC’s first step is to engage champions to advocate and support improvement projects that address maternal and infant health across the District
STEP 2: Multidisciplinary teams are formed to implement the quality improvement process.
STEP 3: Data is collected, analyzed and shared over time with the DCPQC group and other stakeholders. This allows the team to understand the root causes and barriers to prioritize improvement processes.
STEP 4: Continuous monitoring of data allows the team to evaluate successes and identify areas for further improvement.
Between 2016 and 2019, 16% of birthing patients had gestational or pre-existing hypertension. In response, the DCPQC began implementing the Alliance for Innovation on Maternal Health’s (AIM) Severe Hypertension in Pregnancy patient safety bundle in all five of the District’s birthing hospitals in August 2021. The percentage of birthing facilities that have patient education materials on urgent postpartum warning signs increased from 0% in Q4 2021 to 80% in Q3 2023. Between Q4 2021 and Q4 2023, the proportion of women receiving Timely Treatment of Persistent Severe Hypertension increased from 35.9% to 85.4%. The DCPQC is now in sustainability mode for the Severe Hypertension in Pregnancy patient safety bundle. The AIM Severe Hypertension in Pregnancy Maternal Patient Safety Bundle provides guidance to hospitals to coordinate and standardize the care provided to women with severe hypertension during pregnancy and in the postpartum period.
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According to the Alliance for Innovation on Maternal Health (AIM), “postpartum hemorrhage is a leading cause of preventable, pregnancy-related illness and death, with an estimated 54-90% of all OB hemorrhage related deaths being preventable”1. For the first three quarters of 2023, 11% of women experienced hemorrhage during a DC hospital birth admission. Of those, 21% experienced severe maternal morbidity (excluding transfusion).
We are excited to announce the DC Perinatal Quality Collaborative’s (DCPQC) effort among birthing centers to reduce maternal mortality and severe maternal morbidity and provide safe care for every mother. As DC birthing hospitals move forward with sustaining their hypertension related improvements, the DCPQC is prepared to pivot to focus on other important maternal health issues in support of quality improvement. The DCPQC began working on the AIM Hemorrhage bundle in April 2024.
The AIM Obstetric Hemorrhage in Pregnancy Patient Safety Bundle provides guidance to hospitals to coordinate and standardize the care provided to women with obstetric hemorrhage during pregnancy and in the postpartum period.
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The Alliance for Innovation on Maternal Health’s (AIM) Perinatal Mental Health Conditions Patient Safety Bundle provides guidance to hospitals to coordinate and standardize the care provided to women with perinatal mental health conditions during pregnancy and in the postpartum period.
The DCPQC is working on forming a Perinatal Mental Health Planning Workgroup in preparation for the implementation of the perinatal Mental Health Conditions Patient Safety Bundle. This planning group will meet to identify and establish treatment and resources needed to implement the bundle in our future QI work.
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The Alliance for Innovation on Maternal Health’s (AIM) Postpartum Discharge Transition Patient Safety Bundle provides actionable steps that can be adapted to a variety of facilities and resource levels to improve quality of care and outcomes during a critical period in which patients are at risk for morbidity and mortality.
The DCPQC is working on forming a Postpartum & Transitions of Care Workgroup to focus on the connection between hospitals and primary care/outpatient services. This workgroup will meet to identify priorities and develop an action plan to close any gaps in the transition of care between hospitals and outpatient services.
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The District of Columbia Perinatal Quality Collaborative Grant is managed by the District of Columbia Hospital Association Program Services Company, Inc.
This DC Perinatal Quality Collaborative Grant Program is funded wholly or in part by the Government of the District of Columbia Department of Health.