I. Project Abstract Summary
Background. Between 2008 and 2013, the maternal mortality ratio in Colorado nearly doubled, rising from 24.3 to 46.2 deaths per 100,000 live births, with deaths due to behavioral health conditions like suicide and substance misuse driving the increase. Maternal mortality rates are disproportionately higher in certain populations, including black Coloradans and those who live in rural areas. Colorado’s Maternal Mortality Prevention Program (MMPP) has been working to track and prevent maternal mortality for several decades, and now aims to build on its work.
Purpose. The purpose of the proposed project is to reduce pregnancy-related complications and prevent maternal deaths by improving the maternal mortality review process and implementing recommendations for prevention through clinical quality improvement, public health programs, and community-led interventions, including evidence-based interventions to reduce disparities and achieve health equity in maternal health outcomes.
Outcomes. The outcomes listed below are expected from this project.
Increased timely, accurate, and standardized information available about deaths during pregnancy and the year after the end of pregnancy, including opportunities for prevention, within and across funded jurisdictions.
Increased awareness of the existence and recommendations of the MMRC among the public, clinicians, and policy makers.
Increased implementation of data-driven recommendations and interventions, such as evidence-based practices, screenings, and patient education by providers.
Intermediate: Widespread adoption of patient safety bundles and/or policies that reflect the highest standards of care.
Long-term: Reduction in maternal complications of pregnancy.
In addition to these outcomes, the project aims to reduce disparities in maternal complications of pregnancy.
Strategies. The project will use the strategies below to achieve these outcomes.
Maintain a multidisciplinary Maternal Mortality Review Committee: Continue the work of the committee and expand it to include experts in behavioral health.
Comprehensively identify pregnancy-associated deaths: Use data from vital statistics and other sources, and add Medicaid claims data and prescription drug prescribers. Explore the use of next-of-kin/key informant interviews.
Completely abstract available data to support multidisciplinary review of each death: Create a case management system to track and store a variety of records, and facilitate a faster and more complete review. Add abstractors to improve the timeliness of abstraction.
Use data from reviewed deaths for action: Analyze and disseminate findings and trends. Implement interventions based on findings through public health programs, clinical quality improvement, and community-led interventions.