Client: Obstetricians and other clinicians affiliated with 32 birthing hospitals participating in a perinatal quality collaborative.
Challenge: Nearly 16% of people who gave birth in US hospitals in 2019 were affected by hypertensive disorders, which increase the risk of pregnancy-related death. Black individuals are significantly more likely to experience high blood pressure during pregnancy and have higher maternal morbidity and mortality rates. A contributing factor is that not all providers have reliable, evidence-based processes in place to address dangerously elevated blood pressure during pregnancy and in the postpartum period.
Solution: HQI produces training, facilitates peer-to-peer learning, analyzes data and offers resources for implementing the Alliance for Innovation on Maternal Health’s (AIM) severe hypertension bundle. The bundle includes a model protocol for treating patients with a blood pressure reading greater than or equal to 160/110. A primary goal is to initiate treatment of severe hypertension within 60 minutes of onset by removing barriers to rapid administration of magnesium sulfate therapy.
Results: All the birthing hospitals in the state implemented the AIM bundle, which has increased access to potentially life-saving care for pregnant people with severe hypertension. The hospitals collect and report data for their performance on the “60-minute measure” and have set improvement goals. Participants expect to see a decrease in maternal mortality and associated race-based disparities.
Sponsor: This project is funded by the Maryland Department of Health (MDH) and is one of two initiatives underway through the Maryland Perinatal-Neonatal Quality Collaborative, which HQI manages on MDH’s behalf.