December 20, 2018

Increasing efforts to reduce maternal mortality in Missouri

JEFFERSON CITY, MO -In an effort to decrease the number of maternal deaths in the state, the Missouri Department of Health and Senior Services (DHSS) has partnered with many other state agencies and external stakeholders to implement new measures focused on improving Missouri's national ranking. Missouri is ranked 42nd in the United States for maternal mortality.

The Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG) have expanded the definition of maternal death from the death of a "woman while pregnant or within 42 days" to include "women while pregnant or within one year of the termination of pregnancy."

"We have many wonderful people working to improve healthcare for mothers and babies in Missouri, but they need our help," said Dr. Randall Williams, Department of Health and Senior Services Director. "The State of Missouri has begun the process of implementing three new initiatives under Governor Parson's leadership that I believe will help save moms and their babies' lives." 

As part of the Governor's health care week, one week ago Governor Parson, Department of Social Services Director Steve Corsi, Department of Mental Health Director Mark Stringer and Williams met with key stakeholders at Truman Medical Center to host a roundtable to discuss infant and maternal mortality, and what can be done to reduce the rate of maternal deaths.

"Nearly half of all babies born in Kansas City, Missouri are delivered at Truman Medical Centers," said Devika Maulik, MD, Maternal and Fetal Medicine, roundtable participant. "Knowing that Governor Parson and his team are putting maternal and infant health on the list of Missouri's top priorities means a great deal to the physicians and medical staff who live it every day, and are equally passionate about ensuring the health and welfare of mothers in Missouri along with our state's newest residents."

One of the major changes is Missouri's Pregnancy-Associated Mortality Review (PAMR) Committee will now review the most current data available rather than look back at data from years ago. This reflects the new focus of the committee to review data and make recommendations in real time to try and prevent maternal deaths based on the most recent data.  The Committee has increased its membership and will heighten its study of deaths that occur in hospitals as well as those that occur during the first year after delivery.

DHSS, in partnership with Missouri Hospital Association (MHA) and MO HealthNet, will be applying to join the Alliance for Innovation on Maternal Health (AIM), a national data-driven maternal safety and quality improvement initiative based on proven implementation approaches to improving maternal safety and outcomes in the United States, with an end goal to eliminate preventable maternal mortality and severe morbidity across the country. In addition, MHA will facilitate in implementing patient safety bundles in hospitals statewide to improve safety in maternity care. These safety rulings consist of guidelines to focus on common causes of maternal deaths such as bleeding or pulmonary embolus.

DHSS will also be working with partners to create and implement a perinatal quality collaborative (PQC), which are state networks of teams working to improve the quality of care for mothers and babies. Nationwide, PQCs have contributed to important improvements in health care and outcomes for mothers and babies, including: reductions in deliveries before 39 weeks of pregnancy without a medical reason, reductions in healthcare-associated bloodstream infections in newborns, and reductions in severe pregnancy complications.

DHSS has collaborated with the Office of Administration (OA) Information Technology Services Division (ITSD) and has installed the Maternal Mortality Review Information Application (MMRIA), a standardized data-collection and analysis tool developed by CDC to support essential review functions. The successful implementation of the application in the State Data Center, with guidance from the Office of Cyber Security in OA and the CDC, provides DHSS a technical solution and the ongoing technical support for data collection, review and security.

Another partner to state agencies is the Show-ME ECHO (Extension for Community Healthcare Outcomes) program, which provides training and telemedicine for Missouri providers and patients in various, more specialized topics.

"The state funded Show-Me ECHO program is kicking off two ECHO's focusing on High Risk OB in both rural and urban areas in February 2019," said Gwen Ratermann, Associate Director of Outreach with the Missouri Telehealth Network, Show-Me ECHO. "Both programs will strive to improve maternal and infant care and outcomes by empowering teams utilizing evidence-based practices informed by the social determinants of health."

About the Missouri Department of Health and Senior Services: The department seeks to be the leader in protecting health and keeping people safe. More information about DHSS can be found at health.mo.gov or find us on Facebook and Twitter @HealthyLivingMo.

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