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Projects

NNEPQIN is working closely with the state health departments in New Hampshire, Vermont, and Maine to develop a regularly updated hospital-level report presenting aggregate measures drawn from birth certificate and hospital discharge datasets. Sharing a common data set will enable NNEPQIN to track outcomes over time for QI projects.

NNEPQIN is also working toward joining the Alliance for Innovation on Maternal Health (AIM) program led by ACOG under the auspices of the Council for Patient Safety in Women’s Health Care.

Confidential Review & Improvement Board (CRIB)

CRIB provides independent and confidential case review of unanticipated perinatal outcomes for member healthcare providers.

NH Maternal Mortality Review

NNEPQIN was named in NH Legislation to act as the agent of the state to conduct “the functions of collecting, analyzing, and disseminating maternal mortality information, organizing and convening meetings of the panel, and other substantive and administrative tasks as may be incident to these activities.”

 

Patient Education

RISK: Consequences of a Near Term Birth

Written and Directed by Erik Ewers, Your Story Films, Walpole, NH. Produced by Julie Coffman’ NNEPQIN producer Becky Ewing, MD. Featuring: Michele Lauria, MD, Bill Edwards MD, Andrea Damato and Bonnie Morrissette. Risk is a very human twenty-minute educational DVD that helps patients and their providers understand potential outcomes of elective late preterm delivery through the stories of two moms. Dr. Lauria and Dr. Edwards provide the medical context in language that is accurate and understandable.

We hope this movie will serve as an extender for providers, particularly to be used with those patients who are anxious to deliver early.

The message is not new but the manner in which Mr. Ewers delivers it touches the heart and opens the mind. NNEPQIN is very grateful to have worked with such a gifted artist.

VT/NH VBAC Project Mission

Our goal was to increase the availability and safety of VBAC for patients and providers across NH and VT. Due to the lack of clear national standards, negative press coverage, and excessive medical malpractice awards, the choice of VBAC has been taken away from many women and their physicians. In 2003, we polled providers in NH and VT, and found that 98% wanted to offer VBAC as an option to their patients. It is our strong belief that the decision to have a VBAC is very personal. Only a woman and her family, with input from her obstetric provider, can make this choice.

In addition, we feel that VBAC can be safely performed in community hospitals without excessive use of resources when patients are stratified by their risk. Low risk VBAC candidates are at the same risk for an adverse obstetric event as a woman undergoing her first labor. This does not require extensive modifications of routine care processes. Following TJC guidelines for the provision of obstetrical care is adequate.

Medium risk patients can be easily identified and offered care at medical centers with 24-hour in house anesthesia and operating room personnel if desired by the patient and her provider. Few women will become high risk for uterine rupture during their labor. When this occurs, anesthesia and operating room personnel should become immediately available. Many women will have an indication for cesarean delivery at this point, and resources will be used effectively.