Maternal mortality and severe maternal
morbidity (SMM) increased significantly and continuously in the
United States (US) over the past 30 years. A considerable
proportion of these adverse events are attributable to preventable
harm and unintended consequences arising from clinical practice and
the system of delivering perinatal care. To address these alarming
trends, AHRQ has developed the Safety Program in Perinatal Care
(SPPC). During its initial phase (SPPC-I), the program was
comprised of three pillars: teamwork and communication, patient
safety bundles, and in situ simulations. Despite several promising
results, the evaluation of SPPC-I revealed considerable hospital
attrition due to heavy data burden and competing safety
initiatives. Also, differences in the local adaptation of the
SPPC-I patient safety bundles selected by implementation sites
thwarted a meaningful cross-site comparison of programmatic impact.
The current, second phase of the program (SPPC-II), focuses on
integrating the teamwork and communication pillar into patient
safety bundles developed by key professional organizations and
implemented in 20+ US states with technical assistance by the
Alliance for Innovation on Maternal Health (AIM) program and
funding from the Health Resources and Services Administration
(HRSA). Of note, the model used by AIM to implement these bundles
is through statewide perinatal quality collaboratives (PQC) aiming
to enroll all birthing hospitals in the state in the PQC. During
the Planning Phase of SPPC-II, the contractor, Johns Hopkins
University (JHU), developed SPPC-II Training Toolkits for two AIM
patient safety bundles: obstetric hemorrhage and severe
hypertension in pregnancy. The aim of the SPPC-II Demonstration
Project is to implement and evaluate an integrated AIM-SPPC II
program that overlays the SPPC-II Training Toolkits and the AIM
patient safety bundles and program infrastructure in two states --
Oklahoma (OK), currently implementing the severe hypertension
bundle; and Texas (TX), currently implementing the hemorrhage
bundle. Over the next five years, the AIM program is expected to
cover about two thirds of US states. Therefore, there is need to
determine the feasibility and impact of the proposed integrated
AIM-SPPC II program, and inform future government funding decisions
regarding these two programs. To this end, the SPPC-II
Demonstration Project has the following goals: 1) To implement the
integrated AIM-SPPC II program in birthing hospitals in OK and TX
in coordination with AIM and the respective state PQC; 2) To assess
the implementation of the integrated AIM-SPPC II program in these
hospitals; and 3) To ascertain the short- and medium-term impact of
the integrated AIM-SPPC II program on hospital (i.e. perinatal
unit) teamwork and communication, patient safety, and key maternal
health outcomes.
US Code:
42
USC 299 Name of Law: Healthcare Research Act of 1999
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