Illinois Perinatal Quality Collaborative Working Together for Healthier Moms and Babies in Illinois

The Illinois Perinatal Quality Collaborative (ILPQC) has become a national leader in statewide quality improvement (QI) in the three years since its launch expanding from 50 to over 100 participating birthing hospitals, efficiently facilitating QI initiatives with an effective QI model and strategies, and demonstrating steady improvement in reaching our goals for optimized care and improved outcomes for moms and babies in hospitals across Illinois (IL). IL ranks in the top five states with the most births in the nation. In 2014, 158,556 babies were born in IL and 10.2% of these births were preterm, with African American babies 1.5 times more likely to be born preterm and 2.5 times more likely to be very low birth weight (VLBW). In 2012, the IL Perinatal Advisory Committee Prematurity Task Force report to the IL legislature recommended that “resources be provided for a perinatal quality collaborative to work in tandem with the Regionalized Perinatal System (RPS).” Support from the IL CHIPRA Quality Demonstration Grant and March of Dimes brought the Perinatal Quality Collaborative of Illinois (PQCI), a neonatology-focused collaborative started in 2008, together with obstetric (OB) leadership to form a state¬wide perinatal quality collaborative in November 2013. In the past three years, ILPQC has built upon the partnership with IDPH with funding from the Centers for Disease Control and Prevention (CDC) and IDPH to facilitate a three pillar model of QI providing participating hospitals (1) opportunities for collaborative learning, (2) rapid-response data, and (3) QI support. ILPQC successfully completed three statewide QI initiatives with demonstrated improved outcomes. The Early Elective Delivery (EED) Initiative (2013 to 2014) resulted in a reduction in EEDs at 37-38 weeks gestation from 2.33% (2013, quarter 1) to 1.81% (2014, quarter 4) in 47 hospitals. The Neonatal Nutrition Initiative (2014) resulted in a reduction in VLBW infants discharged with weights less than the 10th percentile from 45% (VON 2013) to under 35% (2014, quarter 4) in 18 hospitals. The Birth Certificate Accuracy Initiative (2015) achieved an increase in accuracy of 17 key variables from 87% (Aug-Oct 2014 baseline) to 97% (12/2015) in 86 hospitals. The Maternal Hypertension initiative has already increased the rate of women with new onset severe hypertension treated in 60 minutes or less from 42 to 77% in 8 months. ILPQC has 112 of 120 IL birthing hospitals participating in one or more initiative covering 99% of births and 91% of NICU beds. The purpose of this proposal is to support ILPQC’s work towards the following outcomes monitored using the ILPQC Data and Reporting System and population-based data: • Reduce by 20% maternal morbidity associated with severe hypertension in 110 participating hospitals by reducing time to treatment of severe range maternal hypertension and standardizing patient education and follow up at discharge (Y1) • Increase the use of communication best practices in delivery room resuscitation, including use of a checklist, briefs and debriefs, in greater than or equal to 80% of high-risk deliveries in 23 participating hospitals (Y1) • Expand the number of birthing hospitals participating in ILPQC neonatal projects to 30 through inclusion of Level I/II hospitals in the Neonatal Abstinence Syndrome Initiative (Y2) • Reduce length of stay by 1 day across participating hospitals for full-term infants born with NAS through identification and compassionate withdrawal treatment (Y2-3) • Increase by 75% the use of immediate postpartum LARC in