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Todays webinar will begin in a few minutes. Please press *6 to mute your line or use the mute button on your phone. If you have questions for the presenter or need to contact TCPS staff, type your comments into the chat box. Lines will be opened during the call, so attendees may ask questions. Please do not put the conference on hold. Thank you for your patience. Slide 2 THA HEN/TIPQC OB EED Webinar October 27, 2014 A THA/TCPS TIPQC Collaborative Inter-institutional Quality Improvement Project Slide 3 Faculty Course Director: Peter Grubb, MD, Assistant Professor of Pediatrics, Vanderbilt University School of Medicine; Medical Director, TIPQC Faculty: Brenda Barker, MEd, Project Director, TIPQC Faculty: Chris Clarke, RN, Senior Vice-President, Tennessee Center for Patient Safety, Tennessee Hospital Association Planner/Speaker: Jackie Moreland, RN, Clinical Quality Improvement Specialist, Tennessee Center for Patient Safety, Tennessee Hospital Association Speaker: Phil Toothman, State Director of Communications and Marketing, March of Dimes Speaker: Tamara Currin, MS, MCHES, Associate Director of Program Services, Lead Public Affairs Staff, March of Dimes Speaker: Valencia Mormon-Nelson, State Director of Program Services, March of Dimes Slide 4 Welcome! Agenda for today: November is Prematurity Awareness Month Data Performance Trends Team Successes Questions/Answers from Hospital Teams Slide 5 November is Prematurity Awareness Month Phil Toothman, State Director of Communications and Marketing ~ Tamara Currin, MS, MCHES, Associate Director of Program Services, Lead Public Affairs Staff ~ Valencia Mormon-Nelson State Director of Program Services Slide 6 Upcoming Events 6 th Annual Learning for Babies Conference Thursday November 6, 2014; 7:30a-4:30p CT The Factory at Franklin in Franklin, TN For more information, contact: Tamara Currin at 615-399-3200 or tcurrin@marchofdimes.comtcurrin@marchofdimes.com Slide 7 6 th Annual Learning for Babies Conference Diabetes and Pregnancy - Connie Graves, MD Chorioamnionitis: Maternal and Neonatal Perspective - Chris Sizemore, DO and Travis Crook, MD Interesting Cases from the NICU - Sarah Hassell, MD Update on the Care of Babies with NAS - Stephen Patrick, MD Tips for Dealing with Difficult People - Evelyn Frye, PhD Care of the Parent Experiencing a Prolonged Antepartum and Neonatal Stay - Jennifer Schiro, RN What Can You Really See on Fetal Ultrasound - Michael DeRoche, MD Safe Sleep Practices - Carolyn Riviere, MS, RN Slide 8 Upcoming Events Promoting Healthy Babies Conference Thursday November 13, 2014; 7:30am-3:45pm Baptist Memorial Hospital Memphis Garrett Auditorium For more information, contact: Valencia Mormon-Nelson at 901-590-1722 or vnelson@marchofdimes.comvnelson@marchofdimes.com Slide 9 Promoting Healthy Babies Conference The Role of Prematurity Prevention in Improving Tennessee Birth Outcomes Dr. Michael Warren Using the Preterm Labor Assessment Toolkit: Strategies for Success Barbara Hughes One Familys Story: Preterm Birth Current Tennessee Laws Regarding Maternal Opioid Abuse/Neonatal Abstinence Syndrome (NAS): Effects on Children and Families Break-out sessions on: - Group Prenatal Care - Long Acting Reversible Contraceptive Options for Women - Successfully Breastfeeding Babies Born Prematurely &/or Affected by Neonatal Abstinence Syndrome (NAS) - Ethical Issues Related to Long Term Consequences of Neonatal Abstinence Syndrome (NAS) Slide 10 Prematurity Awareness Month Logo Slide 11 Healthy Babies are Worth the Wait Billboards Slide 12 Night of Purple Memphis Slide 13 Prematurity Awareness Day Facebook Header Slide 14 Nashville Parthenon Lit Up Purple Slide 15 Parthenon on NBC News Slide 16 Ruby Falls Lit Up Purple Slide 17 Ruby Falls Pathway Signage and Lit Purple Slide 18 Tennessee Courthouse Lit Up Purple Slide 19 World Prematurity Day Mark your calendars to recognize World Prematurity Day on Monday November 17 th Slide 20 Prematurity Toolkit To access and download March of Dimes resources such as: Preterm labor assessment toolkit Less than 39 weeks toolkit Prematurity Prevention Resource Center Healthy Babies are Worth the Wait Much more.go to http://www.marchofdimes.org/search- results.aspx?search-text=prematurity toolkit Slide 21 Questions Slide 22 OB EED Data Trends Working toward our goal of 5% or less Slide 23 HEN OB Data Charts Slide 24 Slide 25 Slide 26 Slide 27 OB Statewide Data Charts Slide 28 Slide 29 Slide 30 Slide 31 Questions Slide 32 Sharing Our Successes Slide 33 Congratulations! Slide 34 Safe Sleep Safe Sleep education and book project launch on Friday January 10th 100% of birthing hospitals in Tennessee signed commitment pledge Slide 35 Safe Sleep ABCs of Safe Sleep Babies should sleep ALONE, on their BACK and in a CRIB. http://charlieskids.org/ Slide 36 Hospital Incentive Bundle Free Sleep Baby, Safe and Snug board book for each birth in your facility Free TDH ABCs of Safe Sleep materials Free Recognition on TDH website (http://safesleep.tn.gov)http://safesleep.tn.gov Signed certificate from TDH Commissioner Press release template Slide 37 Antenatal Steroids Brenda Barker, M.Ed. Brenda.Barker@tipqc.orgBrenda.Barker@tipqc.org Slide 38 National Partnership for Maternal Safety Recommends that every birthing facility in the United States should have a Maternal Safety Bundle for each of the following: Obstetric Hemorrhage Preeclampsia/ Hypertension Prevention of VTE in Pregnancy Slide 39 OB Hemorrhage Slide 40 Available OB Hemorrhage Toolkits Slide 41 Preeclampsia CMQCC Preeclampsia Toolkit is now available @ https://www.cmqcc.org/preeclampsia_toolkit https://www.cmqcc.org/preeclampsia_toolkit Slide 42 OB VTE Safety Recommendations For pregnant women, risk of VTE 4-5 times high than for non-pregnant women This risk is at least twice as much following cesarean delivery Key emphasis in addressing risk and prevention by PfP in 2011 as well as dually by ACOG & Society of Maternal Fetal Medicine in 2014 as part of The Maternal Harm Prevention Initiative* *Managing Risk and Reducing Readmissions: New Safety Recommendations Prevent Venous Thromboembolism in Maternal Patients by Michael Wong, JD and Lynn Razzano, RN, MSN, ONCC @ http://ppahs.files.wordpress.com/2014/01/rmq-fall-2013.pdfhttp://ppahs.files.wordpress.com/2014/01/rmq-fall-2013.pdf Slide 43 OB VTE Safety Recommendations Assess each pregnant woman for VTE risk Initiate VTE prophylaxis Reassess each pregnant patient Initiate patient discharge protocols (education to include S/S, prophylaxis post discharge as indicated, long-term effects & prevention strategies)* *Managing Risk and Reducing Readmissions: New Safety Recommendations Prevent Venous Thromboembolism in Maternal Patients by Michael Wong, JD and Lynn Razzano, RN, MSN, ONCC @ http://ppahs.files.wordpress.com/2014/01/rmq-fall-2013.pdfhttp://ppahs.files.wordpress.com/2014/01/rmq-fall-2013.pdf Slide 44 Breastfeeding Slide 45 Ten Steps to Successful Breastfeeding: the Baby Friendly Hospital Initiative 1.Have a written breastfeeding policy 2.Provide staff training in policy implementation 3.Provide breastfeeding education for pregnant women 4.Help initiate breastfeeding within 1 hour of birth 5.Show mothers how to initiate and maintain breastfeeding (even if separated from infant) 6.Give no substitutes unless medically indicated* 7.Practice rooming in 24/7 8.Encourage breastfeeding on-demand 9.Give no artificial nipples/pacifiers to breastfed infants 10.Support and utilize support groups *Hospitals should accept no free or heavily discounted formulas and/or feeding supplies Slide 46 Tennessee Breastfeeding Hotline 24/7 breastfeeding hotline! Dr. Michael Warren, Director, Division of Family Health and Wellness, TN DOH Commissioner John Dreyzehner, MD, MPH Slide 47 Upcoming Events Next THA TCPS/TIPQC OB Monthly Team Webinar Monday November 24, 2014; 10:00am CT/11:00 ET. 2014 THA Leadership Summit Wednesday November 5 th at the Gaylord Opryland Hotel and Convention Center in Nashville in conjunction with THAs Annual Meeting. Go to http://www.tha.com/ for more information and to registerhttp://www.tha.com/ Slide 48 Upcoming Events November Maternal Affinity Group Call: Tuesday November 11, 2014; 12:00-1:00pm CT/1:00-2:00pm ET New Maternal Bundles This session will provide an in-depth overview of the new National Maternal Safety Bundles including suggested resources and recommendations on how to effectively implement these bundles into your organization. FACILITATORS: Elliott Main, MD, FACOG Medical Director of California Maternal Quality Care Collaborative Chairman of the Department of Obstetrics and Gynecology of California Pacific Medical Center and the California Maternal Mortality Review Committee Deb Kilday, MSN, Senior Performance Partner, Premier Inc. REGISTER NOW Register for this call at http://events.premierinc.com/ei/getdemo.ei?id=510&s=_46W0GFBM6http://events.premierinc.com/ei/getdemo.ei?id=510&s=_46W0GFBM6 Slide 49 Upcoming Events 6 th Annual Learning for Babies Conference Thursday November 6, 2014; 7:30a-4:30p CT The Factory at Franklin in Franklin, TN For more information, contact: Tamara Currin at 615-399-3200 or tcurrin@marchofdimes.comtcurrin@marchofdimes.com Slide 50 Upcoming Events Promoting Healthy Babies Conference Thursday November 13, 2014; 7:30am-3:45pm Baptist Memorial Hospital Memphis Garrett Auditorium For more information, contact: Valencia Mormon-Nelson at 901-590-1722 or vnelson@marchofdimes.comvnelson@marchofdimes.com Slide 51 7 th Annual Meeting February 2-3, 2015 Slide 52 Upcoming Events Pre-eclampsia Conference Friday, February 20, 2015 Save the Date! 2 nd Annual OB Conference for nurses & physicians. Guest speakers include Dr. Baha Sibai of the University of Texas Houston and Dr. George Saade of the University of Texas Medical Branch, Galveston RSVP no later than November 30 th to Rebecca.marten@erlanger.org or traci.josephsen@erlanger.org or call 423-778-3222 as venue change may need to occur Rebecca.marten@erlanger.orgtraci.josephsen@erlanger.org This conference is being sponsored by the University of Tennessee, Erlanger Health System, storc (Solutions to Obstetrics in Rural Communities) and Regional Obstetrical Consultants. Slide 53 IHI Open School 2014 THA is providing free access to the IHI Open School curriculum to employees and trustees of our safety partner hospitals. 21 online, self-paced courses including 72 lessons and corresponding resources videos, case studies, podcasts, featured articles, exercises, networking Free app for the iPhone and iPad by logging onto iTunes Over 25 contact hours available for CME, CNE, CPHQ and ACPE credit Certificate of completion 1.Register using instructions. Type Tennessee Hospital Association as your facility to receive free membership. 2.Once registered, go to the course page: www.ihi.org/lmswww.ihi.org/lms 3.Click the online learning tab and choose a lesson 4.Click Begin Lesson Contact Taelor Barnette at tbarnette@tha.com 615-401-7414 for more information.tbarnette@tha.com 53 Slide 54 Resources All material will be posted on the THA HEN Community of Practice (COP) http://www.HealthcareCommunities.orghttp://www.HealthcareCommunities.org Contact tbarnette@tha.com for COP questions or if you need registration and joining instructions.@tha.com THA/TCPS Contacts: Chris Clarke, Sr. VP cclarke@tha.comcclarke@tha.com Jackie Moreland, QI specialist jmoreland@tha.comjmoreland@tha.com Jessy Richter, Data Manager jrichter@tha.comjrichter@tha.com TIPQC Contact: Brenda Barker, M.Ed. Brenda.Barker@tipqc.orgBrenda.Barker@tipqc.org Slide 55 Resources ACOG Statement ACOG practice bulletin, "Induction of Labor" updated in 2010 Tool Kit CMQCC / MOD Tool kit: http://www.cmqcc.org/resources/1974 Websites www.tnpatientsafety.comwww.tnpatientsafety.com www.healthytennesseebabies.comwww.healthytennesseebabies.com user name: hospital password:tnbabies IHI Resources Elective Induction and Augmentation Bundles http://www.ihi.org/knowledge/Pages/Changes/ElectiveInductionandAugmentationBundles.aspx How-to Guide: Prevent Obstetrical Adverse Events @ http://www.ihi.org/knowledge/Page s/Tools/HowtoGuidePreventObstetricalAdverseEvents.aspx Articles A statewide initiative to reduce inappropriate scheduled births at 36(0/7)-38(6/7) weeks' gestation http://www.ncbi.nlm.nih.gov/pubmed/20207241 55 Slide 56 Resources Articles Continued Improving Perinatal Care: A Focus on Patient-Centered Care and Evidenced-Based Measures http://www.ihi.org/knowledge/Pages/ImprovementStories/ImprovingPerinatalCareAFocusonPati entCenteredCareandEvidencedBasedMeasures.aspx Reducing Birth-Related Trauma and Liability Exposure http://www.ihi.org/knowledge/Pages/ImprovementStories/ReducingBirthRelatedTrauma.aspx http://www.ihi.org/knowledge/Pages/ImprovementStories/ReducingBirthRelatedTrauma.aspx Neonatal and maternal outcomes associated with elective term delivery, http://ajog.orghttp://ajog.org Rationale for a 39-Week Elective Delivery Policy http://sitesearch.aafp.org/?q=rationale+for+39+Weeks+policy&x=0&y=0&t1- search=true&sp_cs=UTF-8 http://sitesearch.aafp.org/?q=rationale+for+39+Weeks+policy&x=0&y=0&t1- search=true&sp_cs=UTF-8 Reduction in elective delivery atSlide 57 Resources Patient Resources March of Dimes Resources: Healthy Babies Are Worth The Wait http://www.marchofdimes.com/professionals/medicalresources_hbww.html http://www.marchofdimes.com/professionals/medicalresources_hbww.html Get ready for labor Brain Card Why at least 39 weeks is best for your baby http://www.marchofdimes.com/pregnancy/getready_atleast39weeks.html AWHONN Resources: Go the Full 40 http://www.awhonn.org CMS Innovation Resources Strong Start Toolkit Link http://innovations.cms.gov/initiatives/strong-start/what-you-can-do-to-help.html 57 Slide 58 Data Due Date! Monthly data due by last date of following month! Slide 59