Alaska has a relatively small population with finite financial resources, great geographical distances, costly transports, unpredictable weather, scarcity of specialized care, high hospital staff turnover, and competing health business entities. This backdrop necessitates strong collaborative efforts to optimize perinatal care.
The State of Alaska, Department of Health and Social Services, Division of Public Health, Section of Women’s, Children’s and Family Health (WCFH) is the administrative entity to the Alaska Perinatal Quality Collaborative (AKPQC). The AKPQC has been established to promote high-quality maternal and newborn care across Alaska.
The AKPQC will engage hospitals and birthing facilities in data-driven, collaborative quality improvement focused on reducing severe maternal morbidity. Use of harmful substances during pregnancy continues to be an issue in Alaska and in some cases is increasing. Furthermore, many of the residents living rural areas of Alaska are Alaska Native individuals who experience disproportionate rates of many adverse health outcomes. With input from multiple stakeholders statewide, the AKPQC developed a key driver diagram, change package, and measurement plan, with specific strategies and resources to improve the care statewide of pregnant people and newborns affected by substances.
The Substance Affected Pregnancies Initiative (SAPI) will be the focus of the AKPQC during the first year of the performance period. The AKPQC launched SAPI in September 2021 with seven participating hospitals. It is estimated that hospitals currently participating in SAPI account for 69% of births statewide. Additional participation among interested birthing facilities will be encouraged. SAPI engages hospitals in collaborative quality improvement following the Institute for Healthcare Improvement’s Breakthrough Series model.
The AKPQC proposes to expand implementation of Quality Improvement (QI) initiatives in facilities statewide by supporting a QI Manager. The AKPQC also hosts a data repository on ArcGIS online for facilities participating in SAPI. Facilities can document their progress on initiatives as well as view statewide indicators for comparison. In addition to offering QI support, Alaska is requesting funding to support a data management contract to aid in the maintenance of the ArcGIS Data Repository.
Furthermore, the AKPQC plans to address health disparities and health equity by encouraging motivational interviewing, universal verbal screening for substance use, and intrinsic bias training.
By the end of year one, the AKPQC aims to reduce the proportion of opioid exposed newborns requiring pharmacologic therapy by 20% and increase the proportion of birthing people screened for all substances using a validated tool by 20%.