In August 2018, the LaPQC launched the Reducing Maternal Morbidity Initiative (RMMI), also known as the Safe Births Initiative. It sought to address preventable maternal mortality and morbidity related to hemorrhage and hypertension, while also focusing on reducing racial disparities in these maternal outcomes. Specifically, the RMMI sought to 1) reduce Severe Maternal Morbidity (SMM) by 20% among those persons who experience hemorrhage and/or severe hypertension by May 2020; and 2) decrease the Black-white  disparity in SMM among hemorrhage and hypertension in the same time period. During the RMMI, the LaPQC Planning Team held 18 Coaching Calls, three in-person Learning Sessions, conducted in-person visits through their Listening Tour, and worked with hospitals to engage sound improvement science principles to bring about sustainable change. 

Final SMM data demonstrates that the LaPQC surpassed the goal of a 20% reduction in SMM among hemorrhage( 34.8%), but did not meet the goal of 20 % reduction in SMM among hypertension ( 11.6%). Regarding disparity and SMM among hypertension, SMM among hypertension increased slightly for non- Hispanic Black birthing persons ( 8.1 % increase compared to a 15.7% decrease for non- Hispanic white birthing persons. All hemorrhage and hypertension- related process measures also saw increases in adoption: of note, timely treatment of hypertension increased by 210.8% and quantification of blood loss increased by 171.8%. 

The differences between outcomes in SMM among hemorrhage and hypertension may be due to Louisiana’s longer history of engaging quality improvement work to reduce outcomes related to hemorrhage. Improvement work related to hypertension began over two years after work related to hemorrhage, so processes that reduce SMM among hemorrhage are more resilient and engrained in birthing facilities. The first wave of COVID-19 started to peak in the second quarter of 2020, resulting in staffing and resource shortages; less resilient processes, like those attached to reduction of SMM among hypertension, could be affected by such dramatic shifts in the healthcare landscape. It is still too early to determine the impact of the COVID-19 pandemic on these and other maternal health outcomes. Click HERE for the full report.

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