New Hampshire Enhancing Reviews and Surveillance to Eliminate Maternal Mortality Project - The New Hampshire (NH) Department of Health and Human Services (DHHS) Division of Public Health Services (DPHS), Bureau of Family Health and Nutrition, Maternal and Child Health (MCH) Section houses the NH Maternal Mortality Review Program. This program is coordinated by the MCH Perinatal Nurse Manager, known as the New Hampshire Maternal Mortality Review Committee Coordinator (NH MMRC Coordinator), through contracts funded by the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality Grant (ERASE MM) with the MCH Epidemiologist and the Dartmouth Health-Northern New England Perinatal Quality Improvement Network (DH-NNEPQIN) Perinatal Director of Operations. NH has been reviewing maternal death cases since 2012, after legislation was passed in 2010. The NH Maternal Mortality Review Committee (NH MMRC) is a legislated, multidisciplinary group of clinical and non-clinical members. In the last year, committee members have been added that self-identify as being from or representing a population(s) disproportionately affected by maternal mortality. Review meetings have been designed around the Review to Action website, developed by the CDC Foundation, since November of 2017. NH has had access to the Maternal Mortality Review Information Application (MMRIA) since early 2018 and continues to input all relative maternal mortality data into the system in a timely manner. The NH MMRC continues to conduct comprehensive, multidisciplinary reviews of all NH maternal deaths during pregnancy and that occur within the first year postpartum, regardless of the cause of death. The NH MMRC meets quarterly, and its goal is to determine the pregnancy-relatedness of NH maternal death cases, promote in-depth discussions surrounding the cause of death, and to develop actionable recommendations to reduce NH maternal deaths and promote improved statewide perinatal equitable care, health, and wellness, as well as identify and decrease health disparities. The NH MMRC Coordinator and the DH-NNEPQIN Perinatal Director of Operations have endeavored to conduct timely research and review of all NH maternal death cases within two (2) years of death. DH-NNEPQIN will expand the ability for timely abstraction by hiring a full-time Population Health Perinatal Outreach Nurse, who will replace the DH-NNEPQIN Perinatal Director of Operations, to broaden the abstraction and review process, as well as conduct Informant Interviews. Through case identification within one year of death, collection of records, abstraction, interviews, and all relevant case data entered into MMRIA and ready for review within 18 months of death, the NH MMRC is prepared to review all NH maternal death cases within two (2) years of the death. Full operationalization of MMRIA requires entry and/or import of vital event records on all pregnancy-associated deaths identified. The addition of this team member will increase the MMRC Program’s ability to fulfill this as well as perform data quality assurance checks on all relevant MMRIA forms, based on review of CDC-generated MMRIA Data Quality Reports. A legislated annual NH Maternal Mortality Report is written and submitted to the Joint Legislative Oversight Committee on Health and Human Services. A desired outcome of this grant opportunity is to disseminate the report with its recommendations more widely in NH. Timely data sharing allows pertinent information to create relevancy in the current work being done within NH communities and NH obstetric and family practice settings. Sharing the report will provide awareness of the NH MMRC and its recommendations through dissemination to the public as well as a larger group of organizations through the NH MMRC state webpage, social media, continued collaboration with DH-NNEPQIN’s educational offerings, as well as meaningful engagements and strategizing actionable recommendation implementation with organizations that serve populations disproportionately affected by maternal mortality.
