NYSPQC Past Projects

Obstetrics

Background

Since 2010, the rate of opioid overdose deaths for females of reproductive age, 18 to 44 years old, has tripled in NYS, from 4.2 per 100,000, to 12.7 per 100,000 in 2016.1 Further, the rate of newborns with neonatal withdrawal symptoms and/or affected by maternal use of drugs of addiction was 9.6 cases per 1,000 live births in 2018.2 In response, the New York State Department of Health's New York State Perinatal Quality Collaborative (NYSPQC) led the NYS OUD in Pregnancy & NAS Project. The project's goal was to improve care for both birthing persons with OUD and infants with NAS. The project's pilot phase began in September 2018 with 14 participating birthing hospitals. In October 2020, following the success of the pilot phase, the project was expanded to include an additional 25 NYS birthing hospitals.

Pilot Project Results

  • During the pilot phase of the NYS OUD in Pregnancy & NAS Project, between September 2018 and November 2020, the percentage of participating birthing hospitals with:
    • A universal screening protocol for OUD increased by 238% from 21% in place to 71% in place; and
    • A protocol or process flow to assess and link pregnant people with OUD to support services increased by 119%, from 36% in place to 79% in place.
    • By the end of the pilot phase, all hospitals put in place standardized pharmacologic and non-pharmacologic guidelines for newborns with opioid exposure.

Opioid Use Disorder in Pregnancy

NYSPQC Resources

Other Resources

  • ACOG District II: OUD in Pregnancy Resources | ACOG
  • NYS Authorized Syringe Exchange Programs Site Locations & Hours of Operations
  • NYSDOH Drug User Health Hub Contacts (for Referrals)
  • NYSDOH AIDS Institute Recommendations for Improving Language and Establishing Stigma-Free, Supporting, Service Delivery Environments

Webinar Resources

Neonatal Abstinence Syndrome

Resources

  • This project ran from 2010 to 2014.
  • The NYSPQC Obstetrical Improvement Project specifically sought treduce scheduled deliveries without a medical indication between 36 0/7 and 38 6/7 weeks gestation. By project close, participating RPCs reported a 97% decrease in scheduled deliveries without medical indication during the specified gestation period, including a 96% decrease in inductions and a 98% decrease in cesarean sections. Additionally, primary cesarean sections decreased by 97%, and documentation of maternal education on the risks and benefits of preterm scheduled delivery increased by 124%.
  • Cover Letter: Obstetrical Improvement Project Toolkit
  • Obstetrical Improvement Project Toolkit: Reducing Early Elective Deliveries (PDF)
  • This project ran from 2014 to 2015.
  • In April 2014, the NYSPQC Obstetrical Improvement Project expanded beyond scheduled deliveries to include the focus areas of maternal hemorrhage and hypertension. The maternal hemorrhage and hypertension portion of the project strived to advance improvements in identifying and treating maternal hemorrhage and preeclampsia, eclampsia, and severe hypertension. This was achieved by applying evidence-based interventions to improve capability within NYS birthing hospitals for ongoing quality improvement activities. The NYSPQC provided education on, and highlighted effective strategies for, integrating patient safety practices associated with early identification of maternal hemorrhage, preeclampsia, eclampsia, and severe hypertension into existing infrastructure for care delivery.
  • This project ran from 2015 to 2016
  • The NYSPQC/March of Dimes (MOD) Antenatal Corticosteroid Treatment (ACT) Project enabled participating hospital teams to improve their practices that all mothers of infants born between 23 0/7 and 34 0/7 weeks' gestation receive appropriate ACT to reduce morbidity and mortality.
  • Overview (PDF)
  • This project ran from 2017 to 2021.
  • The project was conducted in collaboration with the American College of Obstetricians and Gynecologists (ACOG) District II, Healthcare Association of NYS and Greater New York Hospital Association, with support from the National Institute for Children's Health Quality.

Project Data & Results

By the close of the project:

  • 100% of participating hospitals had obstetric hemorrhage supplies readily available, typically in a cart or mobile box.
  • 90% of hospitals reported increased use of quantitative blood loss (QBL) measurement for more accurate measurement of blood loss and earlier response to hemorrhage, compared to 41% at the start of the project.
  • Participating hospitals reported a 64% reduction in transfers to ICUs or higher-level hospitals and a 29% reduction in hysterectomies among patients with obstetric hemorrhage.

Neonatal

Background

Since 2010, the rate of opioid overdose deaths for females of reproductive age, 18 to 44 years old, has tripled in NYS, from 4.2 per 100,000, to 12.7 per 100,000 in 2016.1 Further, the rate of newborns with neonatal withdrawal symptoms and/or affected by maternal use of drugs of addiction was 9.6 cases per 1,000 live births in 2018.2 In response, the New York State Department of Health's New York State Perinatal Quality Collaborative (NYSPQC) led the NYS OUD in Pregnancy & NAS Project. The project's goal was to improve care for both birthing persons with OUD and infants with NAS. The project's pilot phase began in September 2018 with 14 participating birthing hospitals. In October 2020, following the success of the pilot phase, the project was expanded to include an additional 25 NYS birthing hospitals.

Pilot Project Results

  • During the pilot phase of the NYS OUD in Pregnancy & NAS Project, between September 2018 and November 2020, the percentage of participating birthing hospitals with:
    • A universal screening protocol for OUD increased by 238% from 21% in place to 71% in place; and
    • A protocol or process flow to assess and link pregnant people with OUD to support services increased by 119%, from 36% in place to 79% in place.
    • By the end of the pilot phase, all hospitals put in place standardized pharmacologic and non-pharmacologic guidelines for newborns with opioid exposure.

Opioid Use Disorder in Pregnancy

NYSPQC Resources

Other Resources

Webinar Resources

Neonatal Abstinence Syndrome

Resources

  • Overview (PDF)
  • The project ran from 2013 to 2015.
  • The objective to eliminate central line-associated bloodstream infections. Among NYSPQC participants, checklist use has increased from approximately 80% to 90% in both RPCs and Level III affiliates during the project period.
  • Overview (PDF)
  • This project ran from 2015 to 2018.
  • The NYSPQC Safe Sleep Project aimed to reduce infant sleep-related deaths by improving safe sleep practices in NYS. Beginning in August 2017, the project entered sustain mode, and through October 2018, the percent of infants, sleeping or awake-and-unattended in a crib, in a safe sleep environment during the birth hospitalization remained stable at around 90%.

    • Resources

    Videos

    • Overview (PDF)
    • This project ran 2010 - 2020.
    • The Enteral Nutrition Improvement Project reduced statewide the percentage of newborns of <31 weeks' gestational age who were discharged from the NICU at weights below the tenth percentile for post menstrual age.