The Florida Perinatal Quality Collaborative’s latest project aimed at reducing maternal morbidity and mortality has begun. The focus of the Hypertension in Pregnancy (HIP) Initiative is to improve proper screening, diagnosis, and management of hypertensive disorders related to pregnancy. The project will emphasize timely recognition, a quick and organized response to severe hypertension cases, and proper patient education and discharge.
On November 6, 2015, 33 Florida hospitals and 1 hospital from Colombia attended a meeting in Winter Park, FL to kick off the HIP Initiative and Florida’s participation in the national AIM program. AIM, or Alliance for Innovation on Maternal Health, is a national partnership of organizations working cooperatively to reduce severe maternal morbidity and mortality falling under the umbrella of the Council on Patient Safety in Women’s Health Care. At the kick off meeting, Jeanne Mahoney, AIM Program Director, welcomed Florida hospitals to this national partnership program.
The day’s training included a moving personal account of preeclampsia from the patient perspective, and a thought-provoking and educational presentation by Eleni Tsigas of the Preeclampsia Foundation on the importance of taking the patient’s perspective into account before, during, and after birth. Participating HIP initiative hospital teams really took home the message that the patient perspective should be considered, noting that educating patients accurately and consistently needs to be better emphasized in their practice.
Drs. Robert Egerman and John Caravello provided a clinical overview of the HIP toolkit recommendations. Dr. William Sappenfield presented on the latest data and the issue of maternal mortality and hypertension in Florida, including the data measures that hospitals will be focusing on as participants in this initiative. The HIP Initiative’s Clinical Lead, Dr. Judette Louis, led a discussion with hospitals on potential solutions to common implementation challenges. Attendees found the interactive discussion where they could hear from other hospitals and learn from one another to be very helpful in beginning to work through the issues as a collaborative. The largest challenge identified was getting physicians engaged. The FPQC plans to conduct on-site technical assistance visits coupled with Grand Rounds presentations for each of the participating HIP initiative hospitals.
A blood pressure clinic, led by Pam Malone-Quarles, Meghan Garland, and Dr. Jean Miles, was very well-received. Participants indicated that they learned more about how important it is to correctly take a blood pressure measurement, how to do so, and the importance of treating elevated blood pressure in a timely fashion. A preeclampsia simulation drill led by Nancy Travis, Megan Gray, and Dr. Salih Yasin emphasized the importance of using the new FPQC hypertensive emergencies algorithm, recommended hypertension medication list, and HIP debriefing form.
Physicians, nurses, and quality experts held large and small group discussions about improving patient safety related to this issue. Evaluations of the event were overwhelmingly positive; attendees noted that it was a very valuable and worthwhile opportunity!
HIP Initiative hospitals will be kicking off the initiative at their sites in January. Each team has assembled a quality improvement team including physician, nurse, and administrative champions. Over the course of the 18 month initiative, the FPQC will provide monthly learning sessions, monthly quality improvement data reports for each hospital, a toolkit and an online toolbox with resources and tools, and technical assistance to assist hospitals in implementing process changes and improving documentation.
For more information on the HIP Initiative, visit our website.