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.
Reconnecting, reinvigorating, and reimaging the future for Tennessee’s Moms and Babies was the highlight of the 15th TIPQC Annual Meeting held Sunday-Tuesday, March 6-8, 2022 in Franklin. With over 250 healthcare professionals, as well as patients & families, and other support organizations, the meeting highlighted national speakers, current Quality Improvement (QI) projects, local hospital quality improvement teams, and poster presentations from across the state.
Commissioner Dr. Morgan McDonald brought greetings from the Tennessee Department of Health (TDH) and reflected on our last in-person meeting coinciding with the first case of COVID-19 and the tornados that swept through our state two years ago, calling this an opportunity for healing, connecting, and building on the strong foundation of care and resiliency in Tennessee healthcare. Komal Bajaj, MD discussed simulation & quality, Aaron Caughey, MD addressed the C-section epidemic, Elizabeth Howell, MD, MPP reminded the audience of health equity regarding maternal mortality and morbidity, Anup Katheria, MD highlighted optimal cord clamping for all infants, Julie Scott, MD spoke on her personal and professional experiences with Maternal Hypertension, Kira Mauseth, PhD shared healthcare resiliency during COVID, Tobi Amosun, MD and Victor Wu, MD, MPH highlighted TDH and TennCare updates, and Karen and Brandi shared their personal pregnancy & birth stories. Dr. Joel Bradley from United HealthCare thanked and greeted the Opioid Hospital Panel which featured the work of Vanderbilt University Medical Center/Monroe Carell Jr. Children’s Hospital, Erlanger Medical Center, The University of Tennessee Medical Center, Knoxville, and TriStar Centennial Women’s and Children’s Hospital. Dr. Rolanda Lister discussed the TIPQC Health Equity Work.
Workshops included Safe to Sleep Project, Maternal Mortality, Health Equity, Maternal Mental Health, Optimal Cord Clamping Project Kick Off, Tennessee’s Tiniest Babies Project, Maternal Hypertension Project Workshop, and QI in the Hospital Newborn Nursery. Workshop speakers included Bethany Scalise, BSN, Jona Bandyopadhyay, MD, Etoi Garrison, MD, PhD, Amita Bey, EdD, Leigh Ann Sutton, LSW, Mary Beth Dunaga, BA, April Hanners, MPH, Julia Wood, MD, and Anna Morad, MD. Additional State project leaders Howard Herrell, MD, Cornelia Graves, MD, Courtney Gutman, MD along with the TIPQC leadership of Scott Guthrie, MD, Jessica Young, MD, MPH, Danielle Tate, MD, MBA, Patricia Scott, DNP, APN, NNP-BC, C-NPT, and Bonnie Miller, MSN lead the workshops. The Mother’s Milk Bank of Tennessee also joined the Annual Meeting.