Health Careers Futures and WHAMglobal Boards Examine Maternal & Child Health Initiatives During Joint Meeting
On June 22, the Health Careers Futures (HCF) and WHAMglobal boards convened in a joint meeting to discuss the evolution, impact, and future of the Pennsylvania Perinatal Quality Collaborative (PA PQC) and related maternal health efforts.
Debra L. Caplan, MPA, chair of WHAMglobal and Jewish Healthcare Foundation (JHF) boards, and Patricia L. Siger, HCF Board co-chair, provided opening remarks on JHF's history around women's health, noting that the PA PQC provides an example of what progress looks like when there is alignment of committed partners, thoughtful plans, and the right team in place.
Robert Ferguson, MPH, JHF chief policy officer, set the foundation for the combined boards' discussion of the origins of and future direction for the PA PQC, which was created through efforts of stakeholders and providers in Pennsylvania who decided the time had come to work together to address the health challenges facing postpartum women. PA PQC Advisory Group co-chairs James A. Cook, MD, director of newborn services at Geisinger Health System, and Aasta Mehta, MD, MPP, chief medical officer of women's health at the Philadelphia Department of Health, discussed the PA PQC's evolution, emerging as a result of work done by the Philadelphia Maternal Mortality Review Committee and the PA Preemie Network, which enabled stakeholders to begin to measure and evaluate data on maternal deaths via surveillance to identify local solutions. The growing opioid crisis subsequently set the stage for a focus on neonatal abstinence syndrome (NAS) and opioid use disorder (OAD) as well as racial ethnic disparities in outcomes for mothers and babies.
The PA PQC was established to act on these focus areas across the commonwealth with an initial grant from Henry A. Hillman Foundation, which allowed PA PQC to then leverage additional funds. To date, PA PQC includes 52 birth hospitals and newborn intensive care units (NICUs) (81% of live births) and 14 health plans. It promotes best practices to reduce racial/ethnic disparities around the focus areas and supports teams to implement key interventions using continuous quality improvement strategies.
Following the adoption of PA PQC Quality Improvement Initiatives, the percentage of hospitals using a validated screening tool to identify maternal substance use increased to 53 percent in 2022.As a result of another PAPQC initiative, 11 of 14 participating hospitals are now routinely counseling and immediately providing postpartum long-acting reversible contraceptives.
PA PQC Teams have increased the number of NICU or well-baby nurses trained in validated NAS assessment by 20 points. Program statistics also show a 29 point increase in the use of standardized non-pharmacologic protocols for NAS and a significant decrease in the number of babies who require medical therapy. In a two-year period, PA PQC teams increased the number of referrals to outpatient community supportive services, from 54 percent to 98 percent. Shawndel Laughner, MHA, BSN, CNML, RNC-OB, director of Women & Children's Services at St. Clair Hospital, shared insights on the impact of PA PQC work on healthcare teams, particularly in regard to morale and satisfaction while working within the challenges that the COVID-19 pandemic presented.
Looking toward the future of the PA PQC, Ferguson summarized the improvement opportunities based on the findings from the first-quarter surveys and comments on the restructured advisory group to help identify priorities. He then moderated a discussion centered on future areas of focus for the PA PQC.
Sally Zubairu-Cofield, MPH, WIC director at the Pennsylvania Department of Health, and Linda Kilby, PhD, RD, LDN, executive director at NORTH, Inc., manager of the Philadelphia WIC program, spoke about how the PA WIC program has been collaborating with statewide stakeholders on current and future goals, including how birth hospitals are increasing referrals to WIC and reducing barriers to access to benefits, such as having unmet social needs.
The meeting concluded with recorded remarks from Representative Lauren Underwood (IL-14) on the status of the Black Maternal Health Momnibus Act of 2021.