CDC Supplement: ILPQC MNO Initiative additional support for provider education and safe discharge planning

Project: Research project

Project Details

Description

Opioid-related poisonings now kills more pregnant/postpartum women in Illinois yearly than any other cause, including hemorrhage or hypertension and infants with Neonatal Opioid Withdrawal Syndrome (NOWS) born in Illinois have longer hospital stays and higher hospital charges than infants without NOWS (IDPH Office of Women’s Health and Family Services, March 2019). In 2018, the Illinois Perinatal Quality Collaborative (ILPQC) launched the Mothers and Newborns affected by Opioids (MNO) Initiative with 110 hospitals working to implement system-wide protocols to improve outcomes for mothers and newborns with opioid use disorder. In 2018, MNO teams started working on system changes and in 2019 teams are continuing these efforts as well as facilitating clinical culture change related to universal screening for opioid use disorder (OUD) prenatally and on labor and delivery, screening, brief intervention and referral to treatment (SBIRT) for women with OUD to link them with Medication-Assisted treatment (MAT) and behavioral health counselling /recovery services prenatally or by delivery discharge, standardizing maternal education on OUD/NAS, educating providers and nurse on stigma reduction and OUD care protocols, and safe discharge planning for opioid exposed newborns (OENs).
ILPQC has realized initial improvements on these initiative aims: MNO-Neonatal hospitals with safe discharge plan implemented increased from 7% of hospital teams (Baseline Oct-Dec 2017) to 20% (March 2019) with an additional 70% currently working on this structure measure. Hospital team work on this structure measure has contributed to improvement in OENs discharged with a safe discharge plan from 38% (Baseline Oct-Dec 2017) to 52% (March 2019). MNO-Obstetric hospitals with providers and nurses educated on OUD protocols has increased from 7% and 8%, respectively (baseline Oct-Dec. 2017) to 45% and 58%, respectively (March 2019). In addition, screening all deliveries for SUD/OUD on labor and delivery with a validated screening tool has increased from 3% at baseline to 41% (Figure 6), while universal screening for SUD/OUD prenatally illustrates an opportunity of focus for continued improvement work in 2019. Women with OUD linked to MAT prenatally or by delivery admission has increased from 41% to 55% and women with OUD linked to behavioral health counselling / recovery support provides another improvement opportunity of focus for 2019).
This supplemental funding opportunity would increase the effectiveness of the ILPQC MNO initiative by providing support for targeted strategies that will help hospital teams achieve the goals of the initiative’s screening, treatment, provider / nurse training, and safe discharge aims to: (1) Improve provider training through (a) increasing the number of providers with waivers to prescribe buprenorphine to treat pregnant and postpartum women and identify opportunities to support these providers and (b) enhancing obstetric provider training resources with simulation guides and targeted grand rounds with a pre grand rounds brief to identify barriers and strategies and a post grand rounds debrief to develop a 30-60-90 day plan to facilitate change at the hospital. (2) Facilitate OUD and OEN protocol implementation among hospital teams through (a) developing additional support resources and quality improvement support to increase the number of hospital teams who implemented protocols for safe discharge plans for OENs and (b) increase the number of hospitals with referral plans in place for safe discharge for women with OUD. Together, these
StatusActive
Effective start/end date9/30/199/29/21

Funding

  • Centers for Disease Control and Prevention (6NU58DP006360-03-01)

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