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Washington Perinatal Quality Improvement Collaborative~ CHARTER

COLLABORATIVE INFORMATION

Team Name: / Team Lead(s): / Date:
Original name: Subcommittee of PAC: C-Section and VBAC Quality Improvement (September 2008- December 2009)
Revised name: Washington Perinatal Quality Improvement Collaborative / Jeff Thompson, MD, MPH and Jane Dimer, MD / Convened September 2008

GOALS

Perinatal Advisory Committee-
Improve quality of perinatal care
Washington Perinatal Quality Improvement Collaborative -
Improve quality of statewide labor and delivery services

HISTORY

The Washington Perinatal Quality Improvement Collaborative, a sub-committee of the statewide Perinatal Advisory Committee (PAC), started convening in September of 2008. The collaborative was convened by the PAC in response to the rise in C-Section rates; both nationally and in Washington State over the past ten years. Washington State’s C-Section rate has risen from 17.2% in 1997 to 29% in 2007. The collaborative is seeking to understand the reason for rising C-Section rates and possible modifiable factors leading to this rise. In addition, the collaborative is looking at factors affecting access to Vaginal Births after Cesareans (VBACs), and possible strategies to reduce the number of statewide C-Sections by decreasing primary C-Sections.
The collaborative is co-chaired by Dr. Jeff Thompson, medical director, Department of Social and Health Services (DSHS – Medicaid) and Dr. Jane Dimer, a Group Health physician and president of the American College of Obstetrics and Gynecology, Washington Chapter. It teleconferences monthly and is currently partnering with hospitals to look at the hospitals’ interest in reducing cesarean sections in their facilities.
The Washington Perinatal Quality Improvement Collaborative thus far has focused on an extensive Quality Improvement hospital survey, literature review including patient decision aides, and a process evaluation to identify best practice priorities. The collaborative believes that variations in the cesarean, VBAC, and induction rates are affecting maternal and infant health across the state of Washington. To address these variations the collaborative is engaging agencies, hospitals, organizations, and the community to encourage birthing hospitals to collaborate and address issues such as inductions, trial of labor, appropriate admissions, and accessibility to vaginal births after cesareans.

STAKEHOLDERS

•  American College of Obstetrics and Gynecology, WA chapter
•  Department of Social and Health Services
•  Department of Health
•  Health Care Authority
•  Washington State Obstetrical Association
•  Washington Academy of Family Physicians
•  Midwives Association of Washington
•  Washington State Hospital Association
•  Foundation for Health Care Quality
•  March of Dimes
•  Hospital Representatives
•  Insurance Providers
•  Legal Representatives
•  Consumer representatives

MILESTONE SCHEDULE

1. Continue monthly teleconferences
2. Completed work: survey to hospitals completed February 2009, literature review completed October 2009, identification of best practices completed October 2009. .
3. Launch perinatal quality improvement website that describes best practices and measures that can be used by WA state providers and Washington state hospitals.
4. Disseminate information to stakeholders using webinars on odd months- September 2009, November 2009, Jan 2010, March 2010, May 2010, and July 2010.
5. Convene an in-person meeting for stakeholders annually.
6. Assess the need for statewide standard reporting and surveillance

SUCCESS CRITERIA & MEASUREMENT

1.  Reduced infant and maternal morbidity as measured by agreed on metrics
2.  Trend toward more hospitals/systems using best practices

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