The Alaska Perinatal Quality Collaborative (AKPQC) was established to promote high-quality maternal and newborn care across Alaska. Perinatal Quality Collaboratives exist in most states and are structured and function based on the needs of the population.
Alaska has a relatively small population, finite financial resources, great geographical distances, costly transports, unpredictable weather, scarcity of specialized care, high hospital staff turnover, and competing health business entities.
This backdrop necessitates strong collaborative efforts to optimize perinatal care. The State of Alaska, Department of Health and Social Services, Division of Public Health, Section of Women’s, Children’s and Family Health (WCFH) is the administrative partner to the Alaska Perinatal Quality Collaborative.
The AKPQC Steering Committee meets the second Thursday of every month from 12 to 1 pm. All are welcome to attend these meetings.
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To provide the highest level of care to mothers and infants across Alaska by collaborating with hospitals, birthing facilities, providers, and key stakeholders to promote the sharing of best practices and advancement of data-driven initiatives.
Engage Hospitals/Birthing Facilities in collaborative quality improvement on issues affecting maternal health through participation in the Alliance on Innovation for Maternal Health (AIM) Program
Engage key stakeholders to explore funding and partnership opportunities to develop a neonatal branch of the AKPQC
Secure funding to sustain maternal quality improvement efforts and to establish a structure for a neonatal branch of the AKPQC
Eliminate preventable maternal and neonatal morbidity and mortality in Alaska
The Alaska Perinatal Quality Collaborative is developing a neonatal initiative to improve care for substance-exposed newborns and their families. As a first step in this initiative, the AKPQC is partnering with the State of Alaska Substance-Exposed Newborns Initiative (SENI) to promote universal verbal prenatal screening utilizing a validated screening tool. The SENI tool relies on the 4P’s Plus©, the only screening instrument for tobacco, drugs, and alcohol that is specifically validated for pregnant people.
SENI is pleased to announce a new partnership with the Alaska Center for Substance Use in Pregnancy and the Newborn, Inc. (ACSUPN). The fundamental mission of ACSUPN is “to help mothers have the healthiest possible pregnancy, to spare their newborn the pain and trauma of substance withdrawal, and to advance their collective futures as a family.”
William (Bill) Trawick, NNP-BC, ACSUPN Executive Director, will be collaborating with SENI staff to develop and implement trainings focused on universal screening utilizing the SENI tool and appropriate management of newborns with substance exposure.
Bill has been practicing within the neonatal intensive care environment for 35 years, and he has been an integral partner throughout the development and implementation of SENI.
SENI is expanding to offer the screening tool and support to additional hospitals, outpatient facilities, birth centers, and midwifery practices. If your facility or practice is interested in screening childbearing people for substances utilizing the validated SENI tool, please email email@example.com.
SENI Publications and Reports
SENI has a limited supply of Nourishing Connections: A Guide for Healthy Breastfeeding by Ira Chasnoff, MD. This is a helpful guide for health care workers to use to educate and counsel patients who are breastfeeding and using substances. If you would like to order a copy of this guide at no cost for your hospital, birth center, or midwifery practice, please email Sherrell.Holtshouser@alaska.gov
Stay tuned to this webpage for more information and initiative resources.
Contact the SENI Program at firstname.lastname@example.org or 907-269-3426.
The 4Ps Plus© is a copyrighted instrument with a licensing fee paid for by the State of Alaska. The SENI Screening Tool many not be used, reproduced, or distributed without the written consent of the SENI Program. Please note that most patients will only require completion of the top half of the tool. The bottom of the tool is completed when a person indicates that they had “any” tobacco, alcohol, or marijuana in the month before they were pregnant.
The Alaska Perinatal Quality Collaborative is convening a multidisciplinary advisory committee to plan an initiative focused on improving maternal and neonatal transfers from planned community (home and birth center) births. Alaska has the highest proportion of community births in the United States and studies suggest that birth outcomes are improved when community birth providers are integrated into the health care system with access to consultation and efficient transfers when escalation of care is needed.
This initiative was adapted with permission from Smooth Transitions, a quality improvement program at the Foundation for Health Care Quality in Washington State. Activities will include the development of local transfer committees to improve collaboration and address systems issues, establishment of standardized transfer protocols and forms, and promotion of protected case reviews that include the transferring provider/practice so that all parties have an opportunity to learn and improve the transfer process.
This initiative will be evaluated through online surveys that ask about experiences with transfers or urgent transports from community births. If you’ve experienced a recent community birth transfer, please consider taking a brief survey based on your role in the transfer. Please complete one survey for each transfer that occurs over the course of this initiative.
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Hypertensive disorders in pregnancy are increasing in Alaska, with hypertensive disorders contributing to two out of the six pregnancy-related deaths in Alaska during 2012-2016. In 2018, nearly 1 in 20 (4.6%) of birthing people in Alaska were diagnosed with preeclampsia. Among those births, over 1 in 10 (10.2%) experienced severe maternal morbidity (SMM). B
ased on these data and feedback from key stakeholders, the Alaska Perinatal Quality Collaborative (AKPQC) launched its first initiative focused on maternal hypertension in March 2019. This initiative engaged six hospitals, representing 63% of Alaska births, in implementation of the Alliance for Innovation on Maternal Health (AIM) Severe Hypertension in Pregnancy safety bundle. Using a collaborative quality improvement framework, participating hospitals were supported through monthly collaborative-wide team and data meetings, quarterly webinars, and technical assistance.
As a result of this initiative and efforts of participating hospitals, the AKPQC exceeded its primary goal by reducing the rate of SMM among birthing people with preeclampsia by 28% from 2018 to 2020. The rate of SMM among preeclampsia cases in 2020 was 7.4%, the lowest rate in the most recent five years. The AKPQC continues to support participating hospitals with sustainability planning and data reporting.
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