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

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 deliv