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Maternal Mortality Overview of the PA PQC July 26, 2019 © 2019 JHF, PRHI, HCF, & WHAMglobal 1 Perinatal Quality Collaboratives (PQCs) PQCs are networks of teams working to identify processes that need to be improved and quickly adopt best practices to achieve collective aims © 2019 JHF, PRHI, HCF, & WHAMglobal 2 PA PQC Aims Reduce maternal mortality and morbidity Improve Identification of and Care for Pregnant and Postpartum Women with Opioid Use Disorders (OUD) Improve Identification of and Care for Opioid-Exposed Newborns (OEN) © 2019 JHF, PRHI, HCF, & WHAMglobal 3 The PA PQC is designed to help birth sites and NICUs drive improvement and adopt standards of care towards the three aims © 2019 JHF, PRHI, HCF, & WHAMglobal 4 PA PQC is Leveraging Statewide Efforts Coordinates with DOH’s, DHS’, and DDAP’s Multi-Disciplinary Workgroup on Infants with Substance Exposure (MDWISE) to disseminate guidelines (e.g., Plans of Safe Care) Serves as an action arm of the PA DOH Maternal Mortality Review Committee (MMRC) PA PA MMRC PQC © 2019 JHF, PRHI, HCF, & WHAMglobal 5 Jewish Healthcare Foundation (JHF) JHF and its operating arms, including WHAMglobal, are helping to standup, administer, and facilitate the PA PQC © 2019 JHF, PRHI, HCF, & WHAMglobal 6 The NEPaPQC is Part of the PA PQC © 2019 JHF, PRHI, HCF, & WHAMglobal 7 Roles of Birth Sites / NICUs Form a multi-disciplinary quality improvement team with maternity and neonatal providers and staff at your site and outpatient clinics Participate in in-person, one-day Learning Collaborative sessions with continuing education credits (four sessions per year) Launch Plan, Do, Study, Act (PDSA) quality improvement cycles in-between the Learning Collaborative sessions, work with community partners on the PDSA cycles, and share what is working well at subsequent sessions to inform the collective work of the group Attend virtual sessions to support your quality improvement projects Access the Vermont Oxford Network’s (VON) NAS Universal Training Program and the VON Day Audits to help your organization become a Center of Excellence for Education and Training for Infants and Families Impacted by NAS (OPTIONAL) Report your aggregate data through the online PA PQC Data Portal and Dashboard on a monthly basis, which will trend your outcomes over time and compare it to the outcomes of other provider teams in the PA PQC © 2019 JHF, PRHI, HCF, & WHAMglobal 8 Roles of Health Plans Form a multi-disciplinary quality improvement team at your health plan Participate in the Learning Collaborative sessions and virtual sessions Engage related contracted resources and care management teams in the PA PQC activities to assist PA PQC providers in your network on quality improvement projects Provide feedback to providers on core metrics that require claims data © 2019 JHF, PRHI, HCF, & WHAMglobal 9 How the PA PQC was Formed © 2019 JHF, PRHI, HCF, & WHAMglobal 10 The PA PQC was Formed through Statewide Collaborative Efforts PA PQC Task Force (facilitated by March of Dimes) AAP PA Premie Network West Chester University Pilot Study with the Vermont Oxford Network (VON) JHF and WHAMglobal helped to form the statewide PA PQC Advisory Group in November 2018 © 2019 JHF, PRHI, HCF, & WHAMglobal 11 PA PQC Work Groups Created the Driver Diagrams and Quality Measures in Early 2019 PA PQC Advisory Group State agencies, providers, health system associations, provider associations, health plans, community-based organizations, researchers, foundations, quality improvement collaboratives, and advocates Maternal Mortality Driver Diagram Work Group Maternal Mortality Quality Metrics Loren Robinson, MD, MSHP Jason Baxter, MD Hyagriv Simhan, MD, MS Stacy Beck, MD Neonatal Abstinence Syndrome (NAS) NAS Quality Metrics Work Group Driver Diagram Work Group Scott Lorch, MD Kimberly Costello, DO Opioid Use Disorder (OUD) OUD Quality Metrics Work Group Driver Diagram Work Group Marian Jarlenski, PhD, MPH Elizabeth Krans, MD, MSc Quality Improvement Methods Work Group Policy Work Group Michael Posencheg, MD Aasta Mehta, MD, MPP Access the Driver Diagrams and Measures here: https://www.whamglobal.org/data-collection © 2019 JHF, PRHI, HCF, & WHAMglobal 12 PA PQC Formation The Wolf Administration announced $500,000 in support of the creation of the PA PQC as part of the $55.9 million Substance Abuse Mental Health Services Association grant. © 2019 JHF, PRHI, HCF, & WHAMglobal 13 Participating Birth Sites/NICUs and Health Plans in the PA PQC © 2019 JHF, PRHI, HCF, & WHAMglobal 14 54 birth sites 11 health plans © 2019 JHF, PRHI, HCF, & WHAMglobal 15 PA PQC Sites © 2019 JHF, PRHI, HCF, & WHAMglobal 16 PA PQC Birth Sites AHN – Forbes Hospital Geisinger – Holy Spirit Hospital AHN – Jefferson Hospital Geisinger – Lewistown Hospital AHN – Saint Vincent Hospital Geisinger – Medical Center, AHN – West Penn Hospital Danville Commonwealth Health – Moses Geisinger – Wyoming Valley Taylor Hospital Hospital Einstein Medical Center Guthrie – Robert Packer Philadelphia Hospital Birthing Center Evangelical Community Hospital Geisinger – Bloomsburg Hospital © 2019 JHF, PRHI, HCF, & WHAMglobal 17 PA PQC Birth Sites AHN – Forbes Hospital Guthrie – Robert Packer Hospital Birthing Center AHN – Jefferson Hospital Jefferson Health – Abington Hospital AHN – Saint Vincent Hospital Jefferson Health – Thomas Jefferson University Hospital AHN – West Penn Hospital Lehigh Valley Health Network – Cedar Crest Commonwealth Health – Moses Taylor Hospital Lehigh Valley Health Network – Muhlenberg Einstein Medical Center Philadelphia Lehigh Valley Health Network – Pocono Evangelical Community Hospital Lehigh Valley Health Network - Schuylkill Geisinger – Bloomsburg Hospital Main Line Health - Bryn Mawr Hospital Geisinger – Holy Spirit Hospital Main Line Health - Lankenau Medical Center Geisinger – Lewistown Hospital Main Line Health - Paoli Hospital Geisinger – Medical Center, Danville Main Line Health - Riddle Hospital Geisinger – Wyoming Valley Hospital Mount Nittany Health System - Mount Nittany Medical Center © 2019 JHF, PRHI, HCF, & WHAMglobal 18 PA PQC Birth Sites Penn Medicine – Chester County Hospital Tower Health Medical Group - Reading Hospital Penn Medicine – Hospital of the University of Pennsylvania UPMC - Altoona Penn Medicine – Lancaster General/Women and Babies UPMC - Charles Cole Penn Medicine – Pennsylvania Hospital UPMC - Hamot Penn State Health Children's Hospital UPMC - Horizon Penn State Health Milton S. Hershey Medical Center UPMC - Magee Womens Hospital Punxsutawney Area Hospital UPMC - Northwest St. Clair Hospital UPMC - Pinnacle Harrisburg St. Luke’s University Health Network – Allentown UPMC - Pinnacle Lititz St. Luke’s University Health Network – Bethlehem UPMC Susquehanna Soldiers + Sailors Temple Health – Temple University Hospital UPMC Susquehanna Williamsport The Midwife Center for Birth & Women's Health © 2019 JHF, PRHI, HCF, & WHAMglobal 19 PA PQC Birth Sites Wayne Memorial Hospital WellSpan Ephrata Community Hospital WellSpan Gettysburg Hospital WellSpan Good Samaritan Hospital WellSpan Summit Health Chambersburg Hospital WellSpan Summit Health Waynesboro Hospital WellSpan York Hospital © 2019 JHF, PRHI, HCF, & WHAMglobal 20 Prenatal & Postpartum PA PQC Birth Clinics Sites Work with Birth Site / Community NICU Community Pediatrics Partners Organizations © 2019 JHF, PRHI, HCF, & WHAMglobal 21 PA PQC Health Plans Aetna Better Health Highmark, Inc. AmeriHealth Caritas PA Independence Blue Cross Community Care Keystone First PA Behavioral Health United Healthcare Gateway Health UPMC Health Plan / UPMC for You Geisinger Health Plan Health Partners Plans © 2019 JHF, PRHI, HCF, & WHAMglobal 22 A Journey through the PA PQC HOW IT WORKS FROM THE PROVIDER’S PERSPECTIVE AND THE ROLE OF HEALTH PLANS AND STAKEHOLDERS © 2019 JHF, PRHI, HCF, & WHAMglobal 23 Journey through the PA PQC Participate in Launch Quality Report Form a Team Learning Improvement Access Resources Aggregate Data Collaboratives Projects © 2019 JHF, PRHI, HCF, & WHAMglobal 24 Step 1: Form a Team Provider Champion for the Maternal Health Team Provider Champion for the Neonatal or Pediatric Team Administrative Champion Data Collection and Reporting Lead Multi-Disciplinary Team for Quality Improvement and Learning Community-Based Organizations Recommended by the Provider Team Your team is not alone…the health plans also formed a team. © 2019 JHF, PRHI, HCF, & WHAMglobal 25 Step 2: Participate in the Learning Collaboratives Identify ideas for starting quality improvement cycles around maternal mortality, OUD, or NAS Learn how context experts and peers in Pennsylvania implemented key interventions for achieving the common aims around maternal mortality, OUD, and NAS Report out on what is working well and what is not working well to inform the collective work of the collaborative © 2019 JHF, PRHI, HCF, & WHAMglobal 26 Step 3: Initiate Quality Improvement Cycles Confirm your goal, baseline data, and QI plan with your PA PQC team When creating your QI metrics, use the PA PQC metrics Initiate the quality improvement plan Make continuous improvements towards the ideal Your team is not alone. Your team can receive QI coaching and technical assistance from the PA PQC staff Health plans, community-based partners, and other stakeholders are participating in the PA PQC to help you Your team can participate in the Vermont Oxford Network (VON) NAS Universal Training Program, VON Day Quality Audits for NAS, and PA PQC webinars © 2019 JHF, PRHI, HCF, & WHAMglobal 27 Step 4: Track Improvement
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