The FIMR Project Shalae Harris, RN, BSN, MPA FIMR Coordinator/Chart Abstractor

 Healthy Babies  Sedgwick County Health Department  Central Plains Regional Health Care Foundation  Kansas Department of Health and Environment  Bureau of Health Informatics  Bureau of Local and Rural Health  SIDS Network of Kansas  Medical Society of Sedgwick County  KUMC– Wichita, Office of Research  Kansas City Healthy Start

 Mahatma Gandhi said, “a nation’s greatness is measured by how it treats its weakest members”.  Our littlest members are key indicators of a community’s well being  Infant health is a measure of community well-being. (NFIMR website, 2001)

 Death of a child under one year of age  Infant death is measured by the infant mortality rate  Infant mortality rate (IMR) is the number of deaths for babies under one year of age in a given year for every 1,000 live births in the same year  The IMR is measured in every country and US state

Source: Heath, United States, 2009

Source: Bureau of Epidemiology and Public Health Informatics, KDHE; National Center for Health Statistics, CDC

 Kansas ranks 29 th in the nation (2007)  Kansas’ rate was 17% higher than US rate (2007)  Kansas ranks #1 in the nation for black infant mortality (2007)

The Causes of Infant Mortality  Low birth weight  Prematurity  Birth Defects  SIDS  Disparities in health care access  Disparities in living conditions  Relational issues  Stress  Environmental conditions Physical Social/Environmental

Source: Bureau of Epidemiology and Public Health Informatics, KDHE

FIMR Fetal Infant Mortality Review

 A collaborative effort of community, county, state, and federal resources to reduce the IMR  An action oriented process that continually assesses, monitors, and works to improve community resources and service delivery systems

The FIMR project is designed to enhance the health and well being of women, infants, and families by improving the community resources and service delivery systems available to them.

 About fault finding or assigning blame for death of the infant  A comprehensive quality assurance program for hospitals or clinics  About conducting original research on the causes of infant death

The FIMR Process

 Data Gathering  Reviews de-identified cases  Identifies interventions to address factors that were associated with the infant death  Implements community based interventions and/or policies for change  Assesses the progress of these interventions and their long term impact on reducing infant mortality

 Notification of death  Case records abstraction  Maternal/Family interview  Case summary  Changes in community systems

 Reviews case data from medical records and family interviews  Identifies trends and gaps in services  Makes recommendations to the CAT for systemic community change

 21 members met July 2010-June 2011  Representing over 20 organizations  22 cases reviewed  25 Cases with attempted interviews  10 Cases with completed interviews 2010 recommendations surround 3 themes: ◦ Education ◦ Connection ◦ Access

 Develops community interventions based on recommendations received  Utilizes existing community resources to implement intervention strategies  Addresses the need for resources and services not currently available

 CAT core team is 15 members  Past year met 6 times  Representing 6 organizations  2 task forces focusing on FIMR CRT education recommendations: ◦ Maternal Tobacco Cessation CAT Task Force ◦ AHBBY CAT Task Force

 Infant health is a measure of community well-being.  FIMR is a community coalition.  FIMR programs engage a diverse membership.  FIMR programs thrive on effective group process.  Action is key to FIMR.  FIMR programs take on a wide range of community action.  FIMR programs build on existing community assets.  The FIMR process is a journey, not a destination.  FIMR programs use population based data.  FIMR programs communicate to the larger community.  FIMR programs recognize and celebrate the work of their team members. NFIMR, National Fetal Infant Mortality Review, ACOG website

 Educate  Bring Awareness  Support  Document

 Dr. Dennis Cooley, Chairperson, Kansas Blue Ribbon Panel on Infant Mortality “Kansas Infant Mortality” PowerPoint, September 2,  Dr. Diane Helentjaris, Virginia Department of Health, “The Silent Epidemic: Uniting to Reduce Infant Mortality” PowerPoint, September 2,  Kansas Department of Health and Environment, Bureau of Family Health, Bureau of Public Health Informatics.  Kansas Department of Health and Environment, Center for Health Disparities  Kansas Blue Ribbon Panel on Infant Mortality,Infant Mortality Factsheet and FIMR concept paper.  TFIMR, Tulsa Fetal & Infant Mortality Review Project, “An Introduction for Prospective Members of the Case Review Team (CRT), PowerPoint,  NFIMR, National Fetal Infant Mortality Review, ACOG website

Shalae Harris, RN, BSN, MPA FIMR Coordinator/Chart Abstractor Sedgwick County Health Department Healthy Babies 434 N. Oliver, Suite 110 Wichita, KS