The purpose of this proposal is to enhance the capacity of the existing Maine Maternal, Fetal and Infant Mortality Review (MFIMR) Panel to identify, review, provide and implement recommendations for prevention of maternal deaths. This proposal moves responsibility for Maine’s Maternal Mortality reviews to the Maine Medical Education Trust, Maine Medical Association - Center for Quality Improvement (MMA-CQI), while maintaining a strong working collaboration with the existing Panel and the Maine Centers for Disease Prevention and Control (Maine CDC), the state public health agency. Four factors contribute to the rationale for this approach:1) Current Panel Coordinator capacity in the Maine CDC is insufficient to conduct comprehensive maternal mortality reviews and related work; 2) Expanding or adding positions to state government, even with funding from external sources, is challenging and often requires years to obtain approval; 3) MMA-CQI has the capacity and expertise to actively support dissemination and action on recommendations related to maternal mortality prevention through the PQC4ME, the statewide Perinatal Quality Improvement Collaborative based at MMA-CQI and other strategies; and 4) the Maine CDC MCH program strongly supports expanding current capacity for maternal mortality review through this collaboration and will assure accountability to the Maine CDC and the U.S. CDC.
Two strategies and related activities are proposed:
Strategy 1: Improve the availability, quality, and timeliness of Maine MMRC data.
• Establish a Maine Maternal Review Committee to focus on maternal mortality as part of the Maine MFIMR Panel
• Review all pregnancy-associated deaths within one year of death
• Abstract records and enter information from medical records, social services, and other relevant sources into MMRIA (Maternal Mortality Review Information Application) within 18 months of each death
• Implement informant interviews, consistent with U.S. CDC guidance
Strategy 2: Improve multi-disciplinary, population-level review of potential pregnancy-related deaths and documentation and dissemination of recommendations for prevention.
• Perform a gap analysis to identify and engage communities and disciplines currently underrepresented on the MFIMR Panel
• Partner with MMA-CQI, PQC4ME, and the Maine CDC to implement quality improvement and other initiatives with communities, clinicians, and policymakers
• Disseminate findings and recommendations for action through conferences, webinars, newsletters, presentations and websites
Activities will be accomplished in partnership with the Maine CDC, the MFIMR Panel Coordinator and in collaboration with professional associations and community organizations. Evaluation will focus on the extent to which short, intermediate and long-term outcomes outlined in the Performance Measurement Plan are met over the two-year funding period.