AKPQC Alliance for Innovation on Maternal Health Hypertension Initiative

Alliance for Innovation on Maternal Health (AIM) Hypertension Initiative

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). Based 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.

AIM Hypertension Initiative Key Driver Diagram and SMART Aim

Background and Foundational Resources

Data Resources

Quality Improvement Resources

March 2020: Resources to develop standard order sets, treatment protocols, and checklists for recognition and response to severe maternal hypertension

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

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

August 2020: Implement patient-centered education of pregnant people and their families on signs and symptoms of severe hypertension/preeclampsia

September 2020:  Establish a system to perform regular debriefs after all cases of severe hypertension

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

December 2020: Implement systems to support patient, families, and staff following a severe maternal event

 AIM Hypertension Initiative Learning Sessions

Email [email protected] for more information.