AKPQC Alliance for Innovation on Maternal Health Hypertension Initiative
Alliance for Innovation on Maternal Health (AIM) Hypertension Initiative
The Alaska Perinatal Quality Collaborative joined the Alliance for Innovation on Maternal Health (AIM) Program in January 2019 and launched its first initiative focused on reducing hypertension-related severe maternal morbidity through state-wide implementation of the AIM hypertension safety bundle. Severe maternal morbidity related to hypertension is highly preventable through implementation of evidence-based practices and quality improvement strategies included in the AIM-supported hypertension safety bundle.
Our goal is to engage all Alaska hospitals and birth facilities in collaborative QI to eliminate preventable hypertension-related severe maternal morbidity. Currently, 6 hospitals are participating in this initiative representing 63% of Alaska births. The AKPQC is supporting facilities through bundle implementation following a collaborative quality improvement (QI) model. This includes monthly team meetings with participating facilities to review data, implementation strategies, and provide a space for mutual mentoring and learning among facilities. The AKPQC is also hosting quarterly learning sessions with topic experts to share best practices.
AIM Hypertension Initiative Key Driver Diagram and SMART Aim
Background and Foundational Resources
- ACOG Committee Opinion: Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period
- AIM Severe Hypertension in Pregnancy Safety Bundle
- The Joint Commission New Standards for Perinatal Safety
Data Resources
- Alaska AIM Monthly Data Spreadsheet
- Alaska AIM Data and Debrief Worksheet
- AIM Data Center Login
- AIM Data Center User Guide
Quality Improvement Resources
- Institute for Health Care Improvement Quality Improvement Essentials Toolkit
- AIM Implement Quality Improvement Projects Toolkit
- Plan Do Study Act Cycle Worksheet
March 2020: Resources to develop standard order sets, treatment protocols, and checklists for recognition and response to severe maternal hypertension
- Hypertensive Emergency Checklist (ACOG District II)
- Hypertensive Emergency Checklist (ACOG District II)
- Eclampsia Checklist (ACOG District II)
- Emergency Department Postpartum Preeclampsia Checklist (ACOG District II)
- Hydralazine Treatment Algorithm (ACOG District II)
- Oral Nifedipine Treatment Algorithm (ACOG District II)
- Hypertension Medication and Monitoring Order Sets (Bartlett Regional Hospital)
April 2020: Ensuring rapid access to IV and PO hypertensive medications
May 2020: May 2020: Train providers and nurses on recognition and response to severe maternal hypertension and accurate blood pressure measurement
- AIM Severe Hypertension in Pregnancy E-Module Introduction
- AIM Severe Hypertension in Pregnancy E-Module Readiness
- AIM Severe Hypertension in Pregnancy E-Module Recognition
- AIM Severe Hypertension in Pregnancy E-Module Response
- AIM Severe Hypertension in Pregnancy E-Module Reporting
- AIM Treating Maternal Hypertension Webinar Recording (February 2017)
- AIM Treating Maternal Hypertension Webinar Slides (February 2017)
June 2020: Executing protocols to treat severe hypertension within 60 minutes
July 2020: Ensure patient follow within 10 days for all patients with severe hypertension and within 72 hours for patients on medications
September 2020: Establish a system to perform regular debriefs after all cases of severe hypertension
- California Maternal Quality Care Collaborative Preeclampsia Toolkit: Teamwork and Communication. Includes strategies for effective team communication and approaches to resolving conflicts.
- Pocket Guide: Team STEPPS. Includes definitions and checklists for briefs, debriefs, and huddles.
- Department of Defense Briefs and Huddles Toolkit. Includes a facilitation guide for training staff on briefs and huddles with videos and case study exercises.
- Florida PQC Debriefing Following a Severe Incident in Pregnancy. Includes tips and promising practices for debriefs
October 2020: Establish a process for multidisciplinary reviews of all cases of severe maternal morbidity
November 2020: Implement systems to identify pregnant and postpartum patients in all hospital departments
- Identifying and treating pregnant and postpartum patients in the ED by Danette Schloeder
- Emergency Care for Patients During Pregnancy and the Postpartum Period: Emergency Nurses Association and Association of Women’s Health, Obstetric and Neonatal Nurses Consensus Statement
- ACOG District II: Emergency Department Postpartum Preeclampsia Checklist
December 2020: Implement systems to support patient, families, and staff following a severe maternal event
- AIM Support after a Severe Maternal Event Safety Bundle
- Communication for Obstetric and Perinatal Events (COPE) Framework
- New Roles for Mental Health Professionals Before, During, and After Severe Maternal Events
AIM Hypertension Initiative Learning Sessions
- Standardized Severe Maternal Morbidity Review: Use of Teams, Tools, and Tracking Slides18.20
- Standardized Severe Maternal Morbidity Review: Use of Teams, Tools, and Tracking Recording 18.20
- Addressing Psychological Impacts of Severe Maternal Events on Providers, Patients, and Families Slides (8/31/20)
- Addressing Psychological Impacts of Severe Maternal Events on Providers, Patients, and Families Recording (8/31/20)
- Management of Postpartum Hypertension/Preeclampsia Slides (2/20/20)
- AIM Hypertension Learning Session Recording (10/15/19)
- AIM Hypertension Learning Session Slides (10/15/19)
- Topics: Case Study, Patient Education, Accurate BP measurement
- AIM Hypertension Learning Session Recording (8/5/19)
- AIM Hypertension Learning Session Slides (8/5/19)
- Topics: Facility Story, AIM HTN Readiness domain, Timely treatment
- AIM Introductory Webinar Recording (3/19/19)
- AIM Introductory Webinar Slides (3/19/19)
Email [email protected] for more information.