PROJECT ABSTRACT SUMMARY
Louisiana is consistently ranked last among multiple health outcomes, placing at the bottom, or near the bottom of every health ranking list available. Louisiana has higher preterm birth rates, maternal mortality and morbidity rates, infant mortality rates, and low-risk cesarean delivery rates compared to much of the country. Across all these key indicators, health outcomes are far worse for non-Hispanic Black patients compared to their non-Hispanic white counterparts. The Louisiana Perinatal Quality Collaborative (LaPQC) was formed in 2017 out of a sense of necessity to have a hub for the implementation of evidence-based practices, using improvement science methods, to address these profound and troubling disparities. The LaPQC is located within the Louisiana Department of Health’s (LDH) Office of Public Health – Bureau of Family Health, the administrator of Louisiana’s Title V Maternal and Child Block Grant program, providing key surveillance and programmatic alignment activities related to maternal- child outcomes. The LaPQC has seen some success in its first 5 years, but there is much work to do; as such, the Louisiana Department of Health is applying for Component A funding through the CDC’s State Based Perinatal Quality Collaboratives work.
Currently, the LaPQC leads improvement work related to breastfeeding and infant nutrition, maternal mortality, morbidity, and birth outcomes, improving the identification, care, and treatment of pregnant and postpartum patients and newborns affected by opioids and substances, supporting pediatric providers to implement best practices related to caregiver perinatal depression screening, and two quality improvement designations – Birth Ready and Gift. Through this funding, the LaPQC hopes to expand all of its current work and launch a new initiative. By the end of the project period, the LaPQC seeks to achieve:
• Decreased racial/ethnic disparities across all outcome measures in LaPQC initiatives;
• An increase in equitable, and overall, application of evidence-based processes across all LaPQC initiatives;
• Increased number of participating facilities that are equipped to quickly and equitably link patients and families to community services;
• Increased number of non-obstetric health care facilities and departments to equitably and quickly address key causes of maternal and infant mortality and morbidity; and
• Increased number of birthing and non-birthing facilities who receive and maintain QI designations as outlined and maintained by the LaPQC.
While the scope and success of the LaPQC has grown considerably since its launch, Louisiana remains a challenging place to address health disparities and the system-level factors that contribute to poor perinatal and neonatal outcomes. The LaPQC integrates health equity work into all initiatives and designations but seeks, with this funding cycle, to expand work in three important ways: expand quality improvement work to non-birthing facilities in an effort to address identified touchpoints of failure that surround pregnant and postpartum mothers; expand the depth and breadth of community and patient engagement both at the collaborative- and facility-level; and routinize reporting of LaPQC work and outcomes to key stakeholder groups including legislators, patients, and birth advocates. Component A funding will allow the LaPQC to continue to push the envelope of what’s possible in terms of patient and community-centered, high-quality, equity-focused, quality improvement work in a state where the health effects of systemic and institutional racism still resonate deeply.