1. March of Dimes 39+ Weeks Quality Improvement Service Package 2012

2. Elimination of Non-medically Indicated Deliveries Before 39 Weeks Toolkit Available at: marchofdimes.com or cmqcc.org

3. 3 QI Service Package Hospital Recognition* *For those hospitals that achieve clear QI implementation process points Grand Rounds Secure Web Based Data Portal Webinars Materials Credit Access to “Experts in the Field”

4. 4 QI Service Package Grand Rounds A National Speakers Bureau in partnership with ACOG and AWHONN members to support hospital Grand Rounds Trained experts in perinatal care and quality improvement

5. 5 Secure Web Based Data Portal Data Portal Goals 1.To help each hospital monitor its own program effectiveness 2.To measure initiative’s overall effectiveness across hospitals

6. 6 Secure Web Based Data Portal Data Portal Reports –Monthly and quarterly reports detailing key indicators and outlining change from previous months both in tabular and graphic form –Reports will include hospital data and comparisons to aggregate data from other hospitals (without hospital identifiers). –Key indicators include the number and percent of early term (37 0/7 – 38 6/7) scheduled inductions and cesarean section deliveries that are non-medically indicated (elective).

7. Sample Report Sample Hospital (SH) HospitalCohort 1 1 Cohort 2 Scheduled Deliveries Scheduled Inductions Elective Scheduled Inductions Measure 3: Percent of scheduled inductions that are elective Scheduled Cesarean Deliveries Elective Scheduled Cesareans Measure 4: Percent of scheduled cesareans that are elective Total Scheduled Deliveries (Inductions and Cesareans) Elective Scheduled Deliveries Measure 5: Percent of all scheduled deliveries that are elective Total Deliveries (scheduled and unscheduled) Measure 6: Percent of all deliveries that are elective NICU Admissions after a Scheduled Elective Delivery Measure 7: Percent of infants admitted to the NICU / special care nursery after a scheduled elective delivery 1 Cohorts will be defined to determine meaningful benchmarks. Prepared by the March of Dimes Perinatal Data Center, 2011 An elective delivery is non-medically indicated. Singleton Early Term Deliveries (37 0/7 through 38 6/7 weeks gestation) January, 2012

8. 8 QI Service Package (Cont’d) Webinars Presented by content leaders from across the country. Step-by-step toolkit implementation guidance will be provided via six 30-60 minute archived Webinars entitled: –Overview of the <39 Weeks Problem and Toolkit Change Components –Outline Medical and Non-Medical Indications <39 Weeks –Data Collection – Baseline and Post Implementation –Establishing Physician & Nursing Leadership and a Medical Hard Stop –Building Consensus – Difficult Provider Q&A –Patient Education

9. 9 QI Service Package (Cont’d) March of Dimes educational materials for consumers/patients to support implementation, including: “Why the Last Weeks of Pregnancy Count” brochures, brain card flyer, and posters

10. Late preterm brain development flyer – consumer. Late preterm brain development card- - provider. “Why the last weeks of pregnancy count” brochure –consumer. Late preterm brain development poster. Poster of pregnant woman wearing “Healthy Babies are Worth the Wait” t- shirt image and message identical to print ad. Sample Materials

11. 11 QI Service Package (Cont’d) Access to “Experts in the Field” Access to a listserv that includes experts as well as providers and other hospitals participating in March of Dimes-supported QI initiatives (e.g., to ask questions, seek advice, share lessons learned, etc.) Monthly “office hours”, which are live chats with national QI experts and providers (e.g., to ask questions, etc.) Experts available on a rotational basis include: –Bryan Oshiro, MD –Donald Dudley, MD –Kathleen Rice Simpson, PhD, RNC, FAAN

12. 12 Hospital Recognition Hospital QI Recognition as “participating in a March of Dimes 39+ Weeks Quality Improvement Initiative…” that includes: –March of Dimes plaque and banner for hospital –Listing on March of Dimes website (www.prematurityprevention.org)www.prematurityprevention.org –Opportunity for co-branding on media campaign!

13. 13 Questions? Contact Lori Reeves @ March of Dimes 321-274-8674 lreeves@marchofdimes.com