SEMPQIC PROJECTS
Michigan Alliance for Innovation on Maternal Health (MI AIM)
In fiscal year 2021, SEMPQIC began formally supporting MI AIM in Region 10 with funding from the Michigan Department of Health and Human Services (MDHHS). The goal of MI AIM is “to eliminate preventable maternal mortality, severe maternal morbidity, and disparity.” This goal is achieved through the implementation of specific clinical protocols which are then reported on by the birthing hospitals. The clinical protocols include Severe Hypertension, Obstetric Hemorrhage, Sepsis, and Reduction of Peripartum Racial/Ethnic Disparities. SEMPQIC has partnered with MI AIM to engage the birthing hospitals in Region 10 in adopting these protocols Bundles.
Our efforts focus on encouraging the the 23 birthing hospitals in Region 10 with the specific goal of improving participation for structural and process variables. These eight hospitals provide data, including trends, to MI AIM and our hospital dashboard. The work began by meeting with each of the hospitals, which resulted in developing crosswalks between existing quality efforts within the hospital and MI AIM Bundle processes. Through this, we were able to improve data submission.
Healthy Baby at Home (HB@H)
SEMPQIC Healthy Baby at Home (HB@H) quality improvement project began in 2017. HB@H serves as a process improvement project to increase home visiting participation for high-risk pregnant women and for babies cared for in an intensive care unit (NICU). These efforts use an evidence-based approach and support existing evidence- based strategies in a meaningful way, while acknowledging social determinants of health and the impacts of inequities in the healthcare delivery system.
The service model consists of providers partnering with Maternal Infant Health Programs (MIHP), and other home visiting agencies, to provide both direct referral and access to their client population for case finding efforts. The agencies are situation on-site to engage clients face-to-face during the referral process, with a mechanism to support communication around referrals being established. Referrals were encouraged for all discharges from the NICU. MIHP referral could occur in conjunction with a skilled nursing home referral. The communication process established referral and feedback processes with providers in the prenatal clinic. Case finding occurred while MIHP agencies were available within clinics to approach potential clients.
Detroit Health Equity Education Resource:
D-HEER
The W.K. Kellogg Foundation (WKKF) awarded SEMPQIC a $450,000 three-year grant (as $150,000 per year) to create the Detroit Health Equity Network, beginning October 2020. The Detroit Health Equity Education Resource (D-HEER) is being developed using a collective impact approach enveloping the “Water of Systems Change,” framework as described by FSG. The intent of using this framework is to shift the conditions that hold disparate birth outcomes in place in Detroit. D-HEER will be an online platform for health equity information, resources, and best practice exchange that will assist organizations to better serve those at high-risk for experiencing maternal and infant mortality. The site will also create community connections that foster capacity growth for agencies to implement equitable policies, practices, and programs that create system change for improved birth and maternal health outcomes. The platform will expand to enable the dissemination of lessons learned statewide and will coordinate efforts with MDHHS in the promotion of the Mother Infant Health and Equity Improvement Plan.
In late 2020, 46 individuals from diverse backgrounds, such as published authors, university leadership, health insurance providers, birthing hospital personnel, federally qualified health centers, medical students, home visitors, breastfeeding proponents, community activists, and faith-based and community-based organizations were invited to participate as members of a Collective Impact Advisory Committee. This committee was tasked with helping to shape the direction of the Network and members were placed into three work groups, each with a specific task in coordinating the Network. The first group worked to identify resource materials and establish criteria for resource selection in the Network. The second group defined the methods for sharing use of the resources with end-users and the community. The third group collected data elements for inclusion in the data dashboard and ensured the evaluation plan for the Network appropriately captures metrics to reflect the impact of this effort. Advisory Committee members actively participate in the D-HEER site, and provided input before the site was made available to the public.
Project Detroit: Voices for Life
Project Detroit: Voices for Life was established to build on existing community assets to examine and replicate circumstances and conditions where Black mothers thrive, empowering Black women to advocate for the best perinatal care experiences, and lead care providers to reach their full potential in providing respectful and equitable care for Detroit women.
Project Detroit: Voices for Life was a major addition to SEMPQIC’s portfolio in 2021. It was funded as part of the second cohort under Merck for Mother’s Safer Childbirth Cities initiative. SEMPQIC received $1 million over three years to support this project, which will impact Black maternal mortality in the city of Detroit. Work on the project began in January 2021, with work in its current fiscal year ongoing.
Program partners include:
The Detroit Health Department, which is focused on establishing a Maternal Mortality and Vitality Review Team to analyze the contributing factors to maternal mortality. This initiative uses an innovative approach to examine maternal deaths and survival aspects at a local level in order to identify potential system enhancements that may reduce the persistent racial disparities in health outcomes in Detroit. Additionally, the Detroit Health Department is enhancing the work of the existing SisterFriends program to recruit “Storytellers” to share their birthing experiences, to change the perinatal narrative for Black and Brown women.
Black Mothers Breastfeeding Association (BMBFA), which is focusing on systems change by working with stakeholders to integrate and sustain community-based doulas as a part of the health care system.
Henry Ford Health System is continuing its work on addressing structural unconscious bias in health care providers by expanding their developed training in collaboration with the March of Dimes.
Focus: HOPE is collaborating with BMBFA and SisterFriends to recruit Storytellers, as well as working with men and fathers to educate them on the roles they can play in improving maternal health outcomes