Starting in spring 2021, 15 birthing facilities in Tennessee joined this project to promote the consistent application of diagnostic and treatment bundles and protocols to optimize the outcomes of patients with hypertensive disorders of pregnancy in conjunction with AIM’s Severe Hypertension in Pregnancy Bundle. Participating hospitals were provided a toolkit, data collection tools, and a road map for implementation. Teams participated in monthly huddles, quarterly learning sessions, and annual meetings. While the global aim was to reduce the rate of severe morbidities in pregnant and postpartum women with severe hypertension, the participating hospitals focused on improving the percent of birthing patients with acute-onset hypertension who are appropriately treated within 1 hour. The five pilot teams, began in November 2020, included Baptist Memorial Hospital, Baptist Memorial, Tipton, Regional One Health, Vanderbilt University Medical Center, and University of Tennessee Medical Center, Knoxville. These teams were able to increase their timely treatment of severe hypertension from 43% to 67% (Quarter 3 of 2020 to Quarter 4 of 2021), a 56% increase. The additional 10 statewide teams began the project in March 2021 and have also improved their timely treatment – from 32% to 57% (a 78% increase). All the participating teams have monitored their timely treatment disaggregated by race and ethnicity to address any possible disparities, having noted great variability among hospitals. These have been addressed utilizing PDSA cycles, particularly removing barriers including translation services. The collaborative and statewide efforts of TIPQC and the participating hospitals have all contributed to this improvement. While the project has already vastly increased the awareness and use of the hypertension protocols, the participating hospitals have continued their efforts to further improve timely treatment after the project went into sustainment June 2022.