ILPQC Immediate Postpartum LARC Quality Improvement Initiative

The rate of unintended pregnancies in the United States is 45% and disproportionately affects women of low socioeconomic status, women ages 18-24, and women of minority racial groups.1 The unintended pregnancy rate jumps to 70% in the first year postpartum and these “short interval” pregnancies are a risk factor for adverse perinatal and neonatal outcomes including preterm delivery.2,3 Intrauterine devices and contraceptive implants, known as long acting reversible contraception (LARC), are safe and effective in reducing unintended pregnancies and their effectiveness could be increased when placed in the immediate postpartum (IPLARC) given that 40 to 60% of women have unprotected intercourse prior to the 6 week postpartum visit and fewer than half of women return for this visit.4,5,6,7,8 The Illinois Perinatal Quality Collaborative (ILPQC) IPLARC Initiative aims to increase by 75% IPLARC insertion among participating hospitals through implementation of systems changes to the obstetric care process flow of counseling patients, accessing LARC, inserting LARC, and billing for LARC. ILPQC is a collaborative made up of teams of obstetric and neonatal providers and nurses from 112 of 120 IL birthing hospitals who work together on quality improvement initiatives using shared data to drive implementation of evidenced based practices and improve care and outcomes for all IL moms and babies. Participating ILPQC hospitals cover approximately 99% of births and 91% of NICU beds in IL. ILPQC, in partnership with IDPH and the LARC Expert Panel, will facilitate a three pillar model of QI providing hospitals participating in the IPLARC Initiative with: (1) opportunities for collaborative learning through monthly team webinars and twice annual in person meetings, (2) rapid-response data to monitor their progress over time and in comparison to other hospitals through the ILPQC Data and Reporting System, and (3) QI support through individual support calls and small group calls with