24 Developing a statewide hospital-based quality improvement initiative to build hospital capacity to address birth equity

Background There are significant racial disparities in maternal mortality In Illinois (IL), with black women six times as likely to die of a pregnancy-related condition as white women. The Illinois Perinatal Quality Collaborative (ILPQC) is developing a statewide hospital-based Birth Equity quality improvement (QI) initiative to build hospital quality improvement capacity using the IHI Breakthrough Series to improve birth equity through collaborative learning opportunities, rapid response data, and QI support. Objectives Our objective is to describe the process ILPQC is using to develop the Birth Equity initiative for implementation. Methods IL birthing hospitals voted to implement a Birth Equity Initiative in late 2018. ILPQC engaged stakeholders to identify Birth Equity as a statewide improvement initiative. We identified 5 interdisciplinary initiative clinical leads who provide clinical expertise on initiative development. ILPQC reviewed 3 state-based PQCs’ approaches to provide birth equity support to hospital teams, resources from 21 organizations, and 24 peer reviewed articles. We identified draft aims, measures, and tools to facilitate system-level changes that lead to clinical culture change. Results We identified four draft key drivers to: (1) address social determinants of health during prenatal, delivery, and postpartum care; (2) utilize race/ethnicity medical record and quality data; (3) engage patients, birth partners, and communities; and (4) engage and educate providers and nurses, to improve birth equity. See the Table 1 for the working version of key drivers and corresponding strategies and measures. Conclusions The ILPQC Birth Equity Initiative will be further developed with input from the initiative clinical leads and stakeholders for implementation with up to the 117 birthing hospitals in IL starting in 2021. ILPQC and hospital teams will monitor progress on initiative measures monthly to inform statewide improvement efforts and evaluate the implementation approach for potential replicability in other states.