The Georgia Department of Public Health (DPH) proposes to enhance the capacity of the Georgia Perinatal Quality Collaborative (GaPQC) to make meaningful, data-driven, equitable improvements in maternal and infant health outcomes through partnership and continuous quality improvement. The GaPQC received the CDC Perinatal Quality Collaborative grant in 2017 and in the years following launched the Alliance for Innovation on Maternal Health (AIM) Obstetric Hemorrhage bundle, AIM Severe Hypertension in Pregnancy bundle, Vermont Oxford Network (VON) Antibiotic Stewardship Initiative and VON Neonatal Abstinence Syndrome (NAS) Universal Training. The GaPQC actively supports hospitals and providers involved in perinatal QI around these initiatives and has demonstrated its ability to make measurable improvements in maternal and neonatal outcomes. We submit this application for CDC-RFA-DP22-2207 Component A to support the continuation of GaPQC efforts to rapidly improve perinatal healthcare and outcomes statewide and reduce disparities in healthcare and outcomes between subpopulations within Georgia.
Georgia has some of the worst perinatal outcomes in the country and GaPQC is uniquely positioned to engage a statewide, multidisciplinary team of partners to implement a multifaceted and integrated approach linked to the key drivers of maternal and infant morbidity and mortality. In Georgia, significant racial disparities exist related to maternal and infant mortality for Black women and women living in under-resourced rural areas. The Georgia Maternal Mortality Review Committee (MMRC) found that non-Hispanic Black women are 2.3 times more likely to die from pregnancy-related causes than non-Hispanic White women and the two leading causes of pregnancy-related death are cardiomyopathy and cardiovascular/coronary conditions. To strategically address these disparities, GaPQC will be the first state in the country to implement the Cardiac Conditions in Obstetrical Care (CCOC) AIM bundle prioritizing outcomes for non-Hispanic Black women and rural Georgians. On the neonatal side, GaPQC is currently enrolling hospitals in a new initiative, Optimizing Nutrition for Georgia Newborns (ON) to address Georgia's increasing Infant Mortality Rate that at 6.1, far exceeds the HP 2030 goal of 5.0.
This application highlights the CCOC initiative which aims to reduce harm related to existing and pregnancy related cardiac conditions through the 4th trimester and GaPQC is currently establishing the percent reduction goal. Objectives include: 1) Readiness: Implementation of standard processes for optimal care of cardiac conditions in pregnancy and postpartum. 2) Recognition & Prevention: Screening and early diagnosis of cardiac conditions in pregnancy and post-partum. 3) Response: Care management for every pregnant or postpartum woman with cardiac conditions in pregnancy and post-partum. 4) Reporting/System Learning: Foster a culture of safety and improvement for care of women with cardiac conditions in pregnancy and post-partum. 5) Respectful, Equitable, and Supportive Care: Inclusion of the patient as part of the multidisciplinary care team.
GaPQC is committed to reducing inequitable maternal and infant care and outcomes. This funding is crucial to support quality improvement initiatives including the CCOC and ON initiatives that target factors disproportionately impacting non-Hispanic Black women and women living in under-resourced rural areas.