FPQC OHI 2.0 Key Resources

• OHI 2.0 Toolkit Document
• OHI 2.0 Key Driver Diagram
• OHI 2.0 Quick Start Guide
• 30-60-90 Day Plan Template
• 30-60-90 Day Plan Example

FPQC OHI 2.0 Data Resources

• Patient-Level Data Collection Form 
• Hospital-Level Data Collection Form
• OHI Baseline Data Form
• Measurement Grid
• OHI 2.0 Data Collection Instructions and Tools

Newest resources since August 2025

Driver 1: Readiness

• Strategies for Improving Postpartum Hemorrhage Outcomes (American Heart Association and EPIC)
• FPQC Post-Birth Bleeding Patient-Facing Flyer – This flyer can be used to help educate patients with hemorrhage risk factors on what to expect if they experience bleeding during or after birth

Driver 3: Response

• OPQIC Patient Summary Form
• H Magnet from South Miami Hospital: Placed outside the door to alert others that the patient is at high risk for hemorrhage
• FPQC Patient Brief Tools on Obstetric Hemorrhage
  • OB Hemorrhage Patient Brief Guidelines and Checklist for Providers
  • OB Hemorrhage Provider and Patient Brief Sample Script
  • EPIC Guidelines - Briefing & Discharge Paperwork
• FPQC Post-Birth Bleeding Patient-Facing Flyer – This flyer can be used to help educate patients with hemorrhage risk factors on what to expect if they experience bleeding during or after birth

• Updated FPQC PACC Patient-Facing Copy of the Post-Birth Health Check – Symptoms to look out for and postpartum support help lines
• PQCNC Life After Postpartum Hemorrhage - Resource for patients to learn what to expect during recovery after a hemorrhage and identify topics they would like more information on
• FPQC Patient Family Advisory Council Implementation Checklist

General Resources

• ACOG Committee Opinion 590: Preparing for Clinical Emergencies in Obstetrics and Gynecology
• ACOG Safe Motherhood Initiative: Obstetric Hemorrhage
• AIM Obstetric Hemorrhage Patient Safety Bundle
• AWHONN Practice Brief Number 13: Quantification of Blood Loss
• The Joint Commission R3 Report: Provision of Care, Treatment, and Services standards for maternal safety
• Strategies for Improving Postpartum Hemorrhage Outcomes (American Heart Association and EPIC)

1a: Develop standardized, facility-wide, stage-based OB hemorrhage emergency management plans

Evidence/Rationale

• ACOG Committee Opinion 664: Refusal of Medically Recommended Treatment During Pregnancy
• ACOG Practice Bulletin 183: Postpartum Hemorrhage
• ACOG Practice Bulletin 211: Critical Care in Pregnancy
• Kawakita et al. 2019 Evaluation of Risk Assessment Tools for Severe Postpartum Hemorrhage in Women Undergoing Cesarean Delivery

Toolkit Resources

• AWHONN Risk Assessment Tool  – You must provide your name and email address to download these free resources
• AWHONN PPH Stages Algorithm
• Revised ACOG Obstetric Hemorrhage Checklist – coming soon
• FPQC Post-Birth Bleeding Patient-Facing Flyer – This flyer can be used to help educate patients with hemorrhage risk factors on what to expect if they experience bleeding during or after birth
• ACOG Massive Transfusion Protocol
• ACOG Declination of Blood Products – Guidance document
• ACOG Obstetric Care Consensus 9: Levels of Maternal Care
• SMFM OB Emergency Transfer Checklist – Maternal transport briefing form and checklist to assist hospitals with emergency transfers
• Hemorrhage Cart Example – Winnie Palmer Hospital
• OB Emergency Transfer Resources – coming soon

Additional Resources

• AWHONN POST-BIRTH Warning Signs Education Program – Structured education program for clinicians with cost involved
• CMQCC Appendix C Obstetric Hemorrhage Care Guidelines Table – Staging algorithm table format
• CMQCC Appendix B Obstetric Hemorrhage Care Guidelines Checklist – Staging algorithm checklist format
• Orlando Health Rapid Response Team Policy
• Orlando Health Epic Order Set Postpartum Hemorrhage
• UF Massive Transfusion Policy
• CMQCC Appendix U Sample Code Crimson Postpartum Hemorrhage Management – OB Emergency Code Guideline Example
• ACOG Obstetric Care Consensus 7: Placenta Accreta Spectrum
• ACOG Identifying and Managing Obstetric Emergencies in Nonobstetric Settings

1b: Ensure rapid access to medications and maintain readily available hemorrhage cart or equivalent

Evidence/Rationale

• Kogutt et al. 2022 Development of an Obstetric Hemorrhage Response Intervention: The Postpartum Hemorrhage Cart and Medication Kit
• Shields et al. 2025 Effectiveness of the Intrauterine Balloon Tamponade Compared With an Intrauterine, Vacuum-Induced, Hemorrhage-Control Device for Postpartum Hemorrhage
• Overton et al. 2024 Intrauterine Devices in the Management of Postpartum Hemorrhage

Toolkit Resources

• Storage and Stability of PPH Medications
• CMQCC Appendix R Medications for Postpartum Hemorrhage
• CMQCC Appendix E OB Hemorrhage Cart, Kits, and Trays

Additional Resources

• Emergency Cart Examples
  • AdventHealth Tampa OB Emergency Cart
  • BUMED Obstetric Hemorrhage Cart Example – Used by military hospitals
  • UF OB Hemorrhage Cart Inventory List
• Revised ACOG PPH Recommended Instruments Checklist – coming soon
• UF Freestanding ED PPH Management Policy

1c: Conduct interprofessional, interdepartmental team-based training and drills to prepare for recognition and treatment of OB hemorrhage

Toolkit Resources

• AHRQ TeamSTEPPS Rapid Response Module
• AIM Patient Safety Learning Modules – Free contact hour for RNs and MDs
• AWHONN Team Debrief Form

Additional Resources

• AWHONN OPS Course
• CMQCC Appendix G OB Hemorrhage Simulations and Drills Sample Scenarios
• CMQCC Appendix F Guidelines for OB Hemorrhage Simulation Scenario Development – Overview on how to create a Simulation Scenario
• CMQCC Appendix AA Sample Script Provider & Patient PPH Post-Event Debrief

1d: Implement a process for timely access to supplies, equipment and procedures for QBL documentation and communication at every birth

Evidence/Rationale

• ACOG Committee Opinion 794: Quantitative Blood Loss in Obstetric Hemorrhage
• Al Kadri et al. 2011 Visual estimation versus gravimetric measurement of postpartum blood loss: a prospective cohort study
• Toledo et al. 2007 The accuracy of blood loss estimation after simulated vaginal delivery

Toolkit Resources

• AWHONN QBL Process Map – Scroll towards the bottom of the page to download pdf
• AWHONN QBL YouTube Video
• CMQCC Appendix M Sample QBL Worksheet

Additional Resources

• QBL Worksheet with Dry Weights Example from the Navy

General Resources

• The Joint Commission R3 Report: Provision of Care, Treatment, and Services standards for maternal safety PC.06.01.01 Reduce the likelihood of harm related to maternal hemorrhage
• ACOG Practice Bulletin Number 183: Postpartum Hemorrhage

2a: Assess hemorrhage risk on admission to L&D, Pre-Birth and on admission to postpartum and prepare based on risk level

Evidence/Rationale

• ACOG Practice Bulletin Number 233: Anemia in Pregnancy
• ACOG Practice Bulletin Number 9: Levels of Maternal Care

Toolkit Resources

• AIM Patient Safety Bundle Learning Module on Obstetric Hemorrhage – Free online module with CME/CE credits available through ACOG, Nursegrid Learn, or HealthStream

Additional Resources

• AWHONN Risk Assessment Tool & Postpartum Hemorrhage Stages Algorithm – You must provide your name and email address to download these free resources
• CMQCC Appendix C: Obstetric Hemorrhage Care Guidelines
• CDC Recommendations to Prevent and Control Iron Deficiency

2b: Measure blood loss with quantitative and cumulative techniques

Evidence/Rationale 

• AWHONN Practice Brief Number 13: Quantification of Blood Loss 
• ACOG Committee Opinion Number 794: Quantitative Blood Loss in Obstetric Hemorrhage
• Al Kadri et al. 2011 Visual estimation versus gravimetric measurement of postpartum blood loss: a prospective cohort study

Toolkit Resources

• See Readiness section 1d for QBL tools
• AWHONN QBL Process Map – Scroll towards the bottom of the page to download pdf
• AWHONN QBL YouTube Video
• CMQCC Appendix M: Sample QBL Worksheet

Additional Resources:

• Example of dry weights from Readiness (1d)

2c: Manage 3rd stage of labor

Evidence/Rationale

• AWHONN Practice Brief Number 12: Guidelines for Active Management of the Third Stage of Labor using Oxytocin
• Begley et al. 2019 Active versus expectant management for women in the third stage of labour, a Cochrane Review

2d: Provide verbal and written education to all patients on OB hemorrhage risk factors, early warning signs, postpartum complications risk, with added counseling for patients at higher OB hemorrhage risk

Evidence/Rationale

• Eaton et al. 2024 Qualitative Analysis of Women's Experiences of Education About POST-BIRTH Warning Signs

Toolkit Resources

• AWHONN POST-BIRTH Warning Signs
• ACOG Respectful Care eModule

Additional Resources

• CDC Hear Her Campaign

General Resources

• ACOG Practice Bulletin 183 on Postpartum Hemorrhage
• The Joint Commission R3 Report: Provision of Care, Treatment, and Services standards for maternal safety PC.06.01.01 EP 6 Reduce the likelihood of harm related to maternal hemorrhage
• Morton et al. 2020 National Partnership for Maternal Safety: Consensus Bundle on Support After a Severe Maternal Event

3a: Utilize a standardized, facility wide, stage-based, obstetric hemorrhage emergency management plan, with checklists and escalation policies for stage-based management of patients with obstetric hemorrhage

Evidence/Rationale

• ACOG Consensus Statement on Levels of Maternal Care
• ACOG Webinar on Placenta Accreta Spectrum Disorder Clinical and Designation Guidelines
• Overton et al. 2024 Intrauterine devices in the management of postpartum hemorrhage

Toolkit Resources

• CMQCC Toolkit version 3.0 pages 113 - 165

Additional Resources

• FPQC Levels of Maternal Care Resources
• LOMC Transfer Protocols – coming soon
• Example Policy for Tamponade Balloon or Vacuum Device – Winnie Palmer Hospital
• Rapid Response Team Policy Examples – Winnie Palmer Hospital
• Triton QBL Calculator Examples – Winnie Palmer Hospital
• JADA System - The JADA® System is intended to provide control and treatment of abnormal postpartum uterine bleeding or hemorrhage when conservative management is warranted
• AWHONN QBL Process Map – Scroll towards the bottom of the page to download pdf. You must provide your name and email address to download these free resources
• ACOG Massive Transfusion Protocol
• H Magnet from South Miami Hospital: Placed outside the door to alert others that the patient is at high risk for hemorrhage
• For hemorrhage carts see 1b

3b: Clinical Team Debrief and Huddles 

Toolkit Resources

• AWHONN Sample Team Debrief Form
• AIM Condition-Specific Questions in Severe Maternal Morbidity Review

Additional Resources

• ACOG Obstetric Team Debriefing Form
• See below for patient brief resources (3c)

3c: Provide trauma-informed support for patients, identified support network, and staff for all obstetric hemorrhages, including discussions regarding birth events, follow-up care, resources, and appointments

Evidence/Rationale 

• Morton et al. 2024 National Partnership for Maternal Safety: Consensus Bundle on support after a severe maternal event
• Vedam et al. 2017a The mothers on respect (MOR) index: measuring quality, safety, and human rights in childbirth
• Vedam et al. 2017b The Mother’s Autonomy in Decision Making (MADM) scale: Patient-led development and psychometric testing of a new instrument to evaluate experience of maternity care

Toolkit Resources 

• AHRQ SHARE Approach – 5-step communication model for shared decision-making

Additional Resources:

• AWHONN POST-BIRTH Warning Signs Infographic
• CMQCC Appendix I Discharge Planning During the Birth Hospital Stay
• OPQIC Patient Summary Form
• FPQC Patient Brief Tools on Obstetric Hemorrhage
  • OB Hemorrhage Patient Brief Guidelines and Checklist for Providers
  • OB Hemorrhage Provider and Patient Brief Sample Script
  • EPIC Guidelines - Briefing & Discharge Paperwork
• FPQC Post-Birth Bleeding Patient-Facing Flyer – This flyer can be used to help educate patients with hemorrhage risk factors on what to expect if they experience bleeding during or after birth
• FPQC Trauma-Informed Care Flyer for Clinicians
• FPQC MFC Webpage – Refer here for a full list of Respectful Care resources
• FPQC PACC Patient-Facing Copy of the Post-Birth Health Check – Symptoms to look out for and postpartum support help lines
• PQCNC Life After Postpartum Hemorrhage - Resource for patients to learn what to expect during recovery after a hemorrhage and identify topics they would like more information on
• Partnering in healthcare: A framework for better care and outcomes – Safer Care Victoria Canadian toolkit to help hospital teams engage patients
• Edinburgh Postnatal Depression Scale
• AHRQ Patient Reported Measure Resources (PREMs)
• Postpartum Support International (PSI) Webpage for Professionals
• PSI Birth Trauma Support – Virtual support group for patients
• Patient Family Advisory Council
  • FPQC Patient Family Advisory Council Implementation Checklist