Addressing the Maternal Mortality Crisis in the Ambulatory Setting: A Quality Improvement Approach

Full Description: The Chicago Collaborative for Maternal Health (CCMH), led by AllianceChicago and EverThrive Illinois, aims to improve maternal health outcomes in the ambulatory care setting via quality improvement initiatives, community engagement, and policy advocacy. AllianceChicago is leading the quality improvement initiative, a population management approach to linking high risk patients to primary care providers in the postpartum period, and has an engaged ambulatory care partners, including FQHCs and hospital clinics, to inform and implement this initiative for their patient populations. This session will discuss CCMH’s unique approach of engaging FQHCs and ambulatory care partners, along with key maternal and public health stakeholders and people with lived experience, to develop and implement quality improvement efforts alongside community engagement in the south and west sides of Chicago to inform policy advocacy at state and local levels, along with discussing the impacts of COVID-19 to the approach and implementation. The session will also review preliminary learnings from QI baseline and implementation data, including the development of an algorithm to identify high-risk prenatal patients and the quality of EHR data impacting that development.
AllianceChicago engaged thirteen partners to inform QI, with seven implementing. We conducted baseline data collection on structure, process, and outcome measures. Structure and process measures include: high-risk criteria defined/implemented; care coordination process identified/implemented; number of staff trained; and number of locations of care implemented. At baseline, three sites had existing high-risk criteria and care coordination processes; no sites had processes linking to primary care. All sites are implementing in at least one location of care with staff trainings in process. The primary outcome measure is the percentage of high-risk patients connected to primary care. The aggregate baseline was 26%. The baseline data is clear there are opportunities for improvement in linking high-risk prenatal patients to primary care after delivery, a crucial time to impact outcomes. From initial learnings, AllianceChicago has developed an algorithm to define and identify high-risk patients to coordinate care, which supports health center capacity and aims for this pilot to be sustainable, replicable, and scalable.
The activities described here are supported by a grant from Merck for Mothers, Merck’s $500M global initiative to help create a world where no woman has to die while giving life, as part of the Safer Childbirth Cities initiative. The content of this submission is solely the responsibility of the grantee organization and does not represent the views of Merck. Merck for Mothers is known as MSD for Mothers outside the United States and Canada.

Abbreviated Description: The Chicago Collaborative for Maternal Health (CCMH), led by AllianceChicago and EverThrive Illinois, aims to improve maternal health outcomes in the ambulatory care setting via quality improvement initiatives, community engagement, and policy advocacy. This session will discuss CCMH’s unique approach of engaging FQHCs and ambulatory care partners, along with key maternal and public health stakeholders and people with lived experience, to develop and implement quality improvement efforts alongside community engagement in the south and west sides of Chicago to inform policy advocacy at state and local levels, additionally discussing the impacts of COVID-19 to the approach and implementation.