(946) Early improvement in implementing key birth equity strategies in a statewide quality improvement effort

The Illinois Perinatal Quality Collaborative (ILPQC) launched a Birth Equity (BE) quality improvement (QI) initiative in July 2021 to address social determinants of health (SDoH), review stratified quality data, engage patients and communities, promote respectful care and develop implicit bias education for care teams. We examined teams’ progress on key strategies in the first 8 months of the initiative and if improvement varied by hospital characteristics.

Study Design: Hospitals reported a random sample of 10 deliveries per month among Black, Indigenous, persons of color and/or patients with public insurance to identify if SDoH screening and linkage to community resources were completed and monthly progress on implementation of systems changes and provider, nurse and other staff implicit bias education. Chi-square analysis was used to test QI measures and binary logistic regression was used to evaluate differences by hospital characteristics in achievement of key measures from baseline (Q4 2020) to Q1 2022.

Results: 63 participating hospitals were included in the analysis. At baseline, 18% (SD=.33) of patients were screened for SDoH, compared to 41% (SD=.46) Q1 2022. Results show that hospital teams achieved significant improvement on all BE key strategies between baseline and Q1 2022 (Table 1, p< .0005). Care team education improved from 20.3% at baseline to 54.1% in Q1 2022 (Figure 1, p=0.001). Progress on initiative strategies from baseline to Q1 2022 did not differ by hospital characteristics.

Conclusion: The results suggest that a statewide collaborative can facilitate an equitable implementation of a statewide QI initiative across diverse birthing hospitals to implement birth equity best practices. Eight months after initiative implementation, hospital teams have already shown improvement in screening for SDoH and linkages to community resources, implementation of key systems changes, as well as provider, nurse and other staff implicit bias education regardless of hospital characteristics.