Florida Perinatal Quality Collaborative
Mother-Focused Care Toolbox
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Secondary driver 1a: Improve the collection of individual patients’ characteristics
NEW! MFC Mid-Initiative Meeting Part 1 - Are Your Stars Aligned?: This webinar was data-focused and provided teams with new clinical pearls and promising practices related to CMS screening requirements. Teams were encouraged to watch in advance of the in-person Mid-Initiative Meeting Part 2. View the recording - Download the slides
Resources:
- Key Driver #1 Presentation
- Refer to Primary Driver #3: “Health-Related Social Needs (HRSN) Screening and Linkage to Services/Resources” for further information on screening.
- ILPQC: Process Flow for Data Collection and Staff Question Formats: Process map to help staff and providers collect data, as well as 3 different formats of questions to assess which best fits their community’s population.
- Thrive Overview: Overview of THRIVE Initiative which helps create a framework for community drivers, and how they impact communities. Also has tools which can be used to help engage providers and stakeholders to recognize and improve current community factors.
- We Ask Because We Care - Poster: Visual representation of the basis for collection of Patient Self-Reported data, which can be used to display around the unit for patients to see.
- We Ask Because We Care - Patient Facing Education: Patient Education on the importance of collection of Patient Self-Reported data.
- Thrive and Aspire documents patient facing documents on importance of real data
- Script for Hospital Staff to Educate Patient: Example script for asking patient about their Self-Reported data.
- Z-Codes: Chart with examples and respective Z-Codes (see Exhibit 1)
Secondary driver 1b: Use Perinatal Quality Indicator & HRSN dashboard to identify disparities. Share findings and build ongoing plans to address identified gaps/strong>
Resources:
- A Framework for Stratifying Race, Ethnicity and Language Data: This guide offers a framework that hospitals can utilize to stratify patient data, to effectively identify healthcare disparities.
- Eliminating Health Care Disparities: Implementing the National Call to Action Using Lessons Learned: Case examples of nine hospitals and health systems summarizing key successes toward eliminating disparities in care.
- New Requirements to Reduce Health Care Disparities: Provides the rationale and references that The Joint Commission employed in the development of the new requirements aimed at reducing health care disparities.
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General Resources
- Key Driver # 2 Slide Deck
- ACOG Committee Opinion 729: Importance of Social Determinants of Health and Cultural Awareness in the Delivery of Reproductive Health Care.
- AWHONN Journal of Obstetric, Gynecologic, & Neonatal Nursing, Clinical Practice Guideline, March 2022: The Respectful Maternity Care Framework
- FPQC PP Mortality Brief Handout: Describes Florida’s high mortality rate, underlying causes and risk factors, and potential preventability and strategies.
Secondary driver 2a: Educate providers and staff about respectful maternity care and its components and strategies
Resources
- FPQC Tool: Suggested Key Components of Respectful Maternity Care (RMC) Trainings: This will help guide teams as they select a curriculum that best meets their hospital’s RMC training needs. (See Driver #2 slides)
- NEW! Physician Engagement in RMC webinar recording and slides
- CDC “Hear HER” Campaign: Free healthcare education on maternal mortality for OBs, pediatricians, and other healthcare professionals. Includes clinical resources and tools, as well as handouts and social media content.
Secondary driver 2b: Develop a hospital commitment with provider and staff support
Resources
- FPQC Tool: Hospital Commitment to Provide Respectful Care: An example of a commitment to RMC that teams can work from as they develop their own.
Secondary driver 2c: Implement and use an ongoing respectful maternity care survey and other methods of maternal feedback to improve care
Resources
- Respectful Maternal Care Survey Patient Education Script: FPQC document with a QR code explaining importance of
- Respectful Maternal Care Survey: FPQC adapted tool for use with postpartum mothers prior to discharge.
Contact fpqc@usf.edu if you are an MFC-participating hospital in need of assistance with the RMC script or survey.
Other Resources
- ACOG Committee Opinion #587: Effective Patient–Physician Communication: Physicians’ ability to effectively and compassionately communicate information is key to a successful patient–physician relationship. The use of patient-centered interviewing, caring communication skills, and shared decision-making improves patient–physician communication. Involving advanced practice nurses or physician assistants may improve the patient’s experience and understanding of her visit.
- ACOG Respectful Care eModules: These courses provide a breadth of knowledge that will help clinicians more effectively offer respectful care in obstetrics, gynecology, and overall patient health. Self-Assessments and CME are offered.
- Respectful Maternity Care Implementation Toolkit (RMC-IT [AWHONN]): The Respectful Maternity Care Implementation Toolkit (free for AWHONN members and available for a small fee for non-members) provides the tools and resources needed to implement the 10-Step “C.A.R.E. P.A.A.T.T.H.” within organizations. Make the commitment today to provide Respectful Maternity Care to every patient, every interaction, every time. CNE are available.
- Operationalizing respectful maternity care at the healthcare provider level: a systematic scoping review: Ensuring the right to respectful care for maternal and newborn health, a critical dimension of quality and acceptability, requires meeting standards for Respectful Maternity Care (RMC). Absence of mistreatment does not constitute RMC. Evidence generation to inform definitional standards for RMC is in an early stage. The aim of this systematic review is clear provider-level operationalization of key RMC principles, to facilitate their consistent implementation.
- Exploring Evidence for Disrespect and Abuse in Facility-Based Childbirth: Reports from a Landscape Analysis (USAID): This is an important review by Bowser and Hill of the evidence on the topic of disrespect and abuse in facility-based childbirth. The primary purpose of the report is to review the evidence in published and gray literature regarding the definition, scope, contributors, and impact of disrespect and abuse in childbirth, to review promising intervention approaches, and to identify gaps in the evidence.
- Respectful Maternity Care: The Universal Rights of Childbearing Women (White Ribbon Alliance): By design, this document focuses specifically on the interpersonal aspects of care received by women seeking maternity services. A woman’s relationship with maternity care providers and the maternity care system during pregnancy and childbirth is vitally important. Not only are these encounters the vehicle for essential and potentially lifesaving health services, women’s experiences with caregivers at this time have the impact to empower and comfort or to inflict lasting damage and emotional trauma, adding to or detracting from women’s confidence and self‐esteem. Either way, women’s memories of their childbearing experiences stay with them for a lifetime and are often shared with other women, contributing to a climate of confidence or doubt around childbearing.
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General Resources
- Key Driver # 3 Slide Deck
- ACOG Committee Opinion #729
- AWHONN Respectful Maternity Care position statement
- ACNM position statement
Secondary driver 3a: Screen all mothers using a standard process and format
Resources
- FPQC algorithm for screening and referral process upon admission to hospital
- Sarasota Memorial Hospital PPT on screening and referral
- EMR examples on workflow for screening and referral process:
- Selected screening tools:
- FPQC Sample of Secondary Questions for screening
- Example screening questions from HCA North Florida
- Example screening form from Jupiter Medical Center
Secondary driver 3b: Link patients to available services and resources for identified HRSN using a community resource directory and other referrals
Resources
- FPQC and Healthy Start Coalition community resource directory template for hospitals in their area (Coming Soon)
- Findhelp.org: Free resource that can help connect patients with community resources
Secondary driver 3c: Educate hospital staff on processes for developing a mutually agreed-upon plan of care utilizing a shared decision-making model
Resources
- FPQC “Shared Decision-Making” snippet (Coming Soon)
- ACOG reference on “Shared Decision-Making”
- ACNM Shared Decision-Making document: ACNM position statement
- The SHARE Approach: The Agency for Healthcare Research and Quality developed a five-step process on shared decision-making that includes a training curriculum and tools
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Secondary driver 4a: Educate QI Team, leadership, providers and staff about family and community advisor involvement
Resources
- The Guide to Patient and Family Engagement in Hospital Quality and Safety: A resource to help hospitals develop effective partnerships with patients and family members with the goal of improving hospital quality and safety. This handbook gives an overview of and rationale for the strategy. It also outlines five steps for putting this strategy into place at hospitals and includes specific suggestions for how to work with patient and family advisors.
- The Institute for Patient-and Family-Centered Care (IPFCC): A website that has numerous resources for hospitals. Several of their free resources are outlined.
- HIPAA & TJC guidelines: Describes family inclusion in QI work.
- Patient Family Centered Care: Learn how hospitals can get started. Free download with guidelines and tips for hospitals getting started with Family Centered Care.
- Clinician Education Modules: This resource contains three modules with educational videos to assist in creating a new patient and family faculty program or expanding an existing program.
- Patient and Family Advisors in Action: Examples from the field that showcase how hospitals are working with patients and families to improve health care. Best practices from several hospitals with videos, tools.
Secondary driver 4b: Engage family and/or community advisors to provide ongoing input on QI efforts and care provision
Resources
- Institute for Patient- and Family-Centered Care: Provides numerous resources to incorporate patients and families in their care.
- The Health Research & Educational Trust (HRET) and American Hospital Association (AHA) Playbook for Fostering Hospital-Community Partnerships to Build A Culture of Health: Provides guidance on engaging patients and partnering with community organizations.
- Family Engagement at the Systems Level: A Framework for Action (MCH Journal): Health systems can use this Family Engagement in Systems framework to support meaningful family engagement in the design of policies, practices, services, supports, quality improvement projects, research, and other systems-level activities.
- Resources from AHRQ on engaging patients and families: