Colorado Maternal Mortality Prevention Program - Although maternal mortality is not common in Colorado, the rates of preventable deaths are increasing and the burden falls disproportionately on Black and American Indian/Alaskan Native populations. Overdoses are driving the increase; unintentional drug overdose contributed to 28.3% of maternal deaths in 2021 compared to 15.6% in 2016. The Maternal Health Program at the Colorado Department of Public Health and Environment oversees the Maternal Mortality Review Committee and plays a vital role in understanding and preventing maternal deaths. The purpose of the proposed project is to (1) continue to review all pregnancy-associated deaths to understand emerging trends, disparities, and causes of maternal mortality; (2) disseminate findings more broadly and strategically to increase uptake in MMRC recommendations; and (3) support the implementation of MMRC recommendations through clinical quality improvement, public health programs, and community-led interventions. These outcomes are expected by the end of the period of performance: ● Increased timeliness, accuracy, and standardization of information available about pregnancy-related deaths, including opportunities for prevention. ● Increased engagement and cooperation between MMRCs, partners, and communities to communicate information from data on pregnancy-related deaths. ● Increased availability of MMRC recommendations among communities, clinicians, public health practitioners, and decision makers. These will lead to increased adoption of clinical and non-clinical policies and programs that reflect the highest standards of care, and increased implementation of recommendations that reach populations disproportionately affected by pregnancy-related mortality. Long term, this will lead to reduced complications during pregnancy and in the year after; elimination of disparities in complications during pregnancy and in the year after; and improved maternal health outcomes. It will also eliminate preventable pregnancy-related deaths. The project will use these strategies: ● Improve the availability, quality, and timeliness of MMRC data with the following actions: fully operationalize the MMRIA system to support core MMRC functions; comprehensively identify maternal deaths; implement approaches for improving quality of death records and timely death record quality assurance to confirm pregnancy status; apply a consistent process and standardized criteria for selecting deaths that will be fully abstracted for committee review; implement informant interview approaches; abstract and enter information from relevant sources about all deaths potentially related to pregnancy into MMRIA within 18 months of death in preparation for committee review for cases selected for multidisciplinary review within 24 months of death; document committee decisions on the MMRIA Committee Decisions Form in MMRIA within 30 days of reviewing a death; perform data quality assurance checks on all relevant MMRIA forms within 90 days of completing the review of a death. ● Improve multidisciplinary, population-level review of pregnancy-related deaths and documentation of recommendations for prevention by maintaining a multidisciplinary MMRC. The Colorado MMRC is diverse in perspectives, disciplines, and life experiences, resulting in a more comprehensive review, richer discussions, and better recommendations. ● Improve dissemination, access to, and employment of quality MMRIA data to drive opportunities for prevention by building on and improving our analytic plan for pregnancy- related MMRIA data; establishing a refreshed dissemination plan for information on pregnancy-related analyses; implementing new dissemination strategies for data products and related information from pregnancy-related analyses; and maintaining bidirectional partnerships with communities that increase the utilization of MMRC data and transparency of MMRC process and data.
