New Hampshire Alliance for Innovation on Maternal Health (AIM) & ERASE Maternal Mortality Projects
For questions or additional information regarding these initiatives, please feel free to contact us: NNEPQIN@hitchcock.org or 603-653-6898
Table of contents
- Alliance for Innovation on Maternal Health (AIM)
- NH AIM FOCUS
- ERASE Maternal Mortality
- New Hampshire Maternal Mortality Review Process
Alliance for Innovation on Maternal Health (AIM)
- National data-driven maternal safety and quality improvement initiative
- Works to reduce preventable maternal mortality and severe morbidity
- AIM works to promote respectful care for all birthing persons, and eliminate disparities in perinatal outcomes
AIM aligns national, state and hospital level improvement efforts
- AIM works with state health departments, Perinatal Quality Collaboratives, hospitals, community-based teams and patient representatives to address the key drivers of maternal mortality and SMM.
- AIM utilizes patient safety bundles as core building blocks to improve outcomes
AIM uses data to drive improvement strategies
- Timely data drives hospital and perinatal quality collaborative QI activities
- Collaboration with state health departments provides data through vital statistics records and all-payer administrative databases
- AIM defines standard process and outcome measures for members, to increase opportunities for learning
NH AIM FOCUS
New Hampshire AIM Patient Safety Bundles Focus
AIM relies on critical collaborations between State Perinatal Quality Collaboratives (PQCs) and Maternal Mortality Review Committees
Recommendations on clinical quality improvement are led by NNEPQIN/NHPQC. The AIM and NHPQC projects are a key component to implementing recommendations to reduce maternal mortality in New Hampshire.
New Hampshire AIM will address two core patient safety bundles in 2021
- Opioid overdose is the leading cause of pregnancy associated death in New Hampshire
- Maternal and neonatal outcomes in New Hampshire show the same racial and ethnic disparities which exist nationally
NH-AIM has identified five key initiatives to drive reduction in Substance-related Maternal Mortality and SMM in New Hampshire
AIM/ERASE Maternal Mortality Monthly Webinars
Held the 2nd Thursday of each month from 12 – 1PM
FLYER FOR JANUARY – JUNE 2025 NH AIM/ERASE MM WEBINARS: FINAL 2025 NH AIM Webinars Flyer
2025 WEBINARS:
May 8, 2025 Webinar: “Team debrief after an unexpected event: Support team and patient well-being“
Slides: May 2025 AIM slides
Recording for CE Credit: May 2025 NH AIM/ERASE Maternal Mortality Webinar Series – Team debrief after an unexpected event: Support team and patient well-being
April 10, 2025 Webinar: “Patient Perspectives on Supports and Services: What Works and What’s Needed”
Slides: April 2025 AIM slides
Recording for CE Credit: April 2025 NH AIM/ERASE Maternal Mortality Webinar Series – Patient Perspectives on Supports and Services: What’s Needed and What Works
March 13, 2025 Webinar: “Creating a community-wide approach to perinatal mental health”
Slides: 3.13.25 NH AIM ERASE MM Handout
Recording for CE Credit: https://dh.cloud-cme.com/course/courseoverview?P=0&EID=153023
February 13, 2025 Webinar: “From screening to action: setting the stage for an honest patient discussion”
Slides: 01272025 February 2025 AIM slides
Recording: February 2025 NH AIM ERASE Maternal Mortality Webinar Recording
For viewing for CE Credit: https://dh.cloud-cme.com/course/courseoverview?P=0&EID=153011
January 9, 2025 Webinar: “Clinical pearls to help address common barriers in providing mental health care”
Slides: 1.9.25 NH AIM ERASE MM Webinar Handout
Recording: January 2025 NH AIM/ERASE MM Recording
For viewing for CE Credit: https://dh.cloud-cme.com/course/courseoverview?P=0&EID=148950
2024 WEBINARS:
December 12, 2024 Webinar: “The importance of improving our birth certificate data collection.”
Slides: December AIM slides FINAL handout
Recording: December+2024+NH+AIMERASE+Maternal+Mortality+Webinar Recording
November 14, 2024 Webinar: “A multidisciplinary team approach to more effective discharge planning.”
Slides: November AIM ERASE webinar slide handout
Recording: November 2024 NH AIMERASE Recording
October 10, 2024 Webinar: “Creating comprehensive postpartum support in these challenging times.”
Slides: 10.10.24 NH AIM ERASE MM Webinar Handout
Recording: October 2024 NH AIMERASE Recording
September 12, 2024 Webinar: “Creating comprehensive postpartum support in these challenging times.”
Slides: September 2024 NH AIM Webinar Handout
Recording: September 2024 NH AIM Recording
August 8, 2024 Webinar: Why a comprehensive SDoH assessment improves your ability to address mental health concerns.
Slides: August 2024 NH AIM Webinar Handout
Recording: August 2024 NH AIM Recording
No July 2024 Webinar
June 13, 2024 Webinar: How to find the right consult when you have a client that needs a higher level of care
Slides: June 2024 NH AIM Webinar Handout
Recording: June 2024 NH AIM Recording
May 9, 2024 Webinar: How to provide appropriate mental health treatment in your community to meet your patients’ needs
Slides: May 2024 NH AIM Webinar Handout
Recording: May 2024 NH AIM Recording
April 11, 2024 Webinar: Utilizing the Plan of Safe and Supportive Care (POSC) to demonstrate patient strengths and link them with community based resources
Slides: April 2024 NH AIM ERASE MM Webinar Handout
Recording: April 2024 NH AIM Recording
March 14, 2024 Webinar: What does patient centered mental health care really look like?
Slides: March 2024 NH AIM Webinar Handout
Recording: March 2024 NH AIM Recording
February 8, 2024 Webinar: Creating a process that ensures a positive screen is addressed appropriately
Slides: Feb 2024 NH AIM ERASE Maternal Mortality Webinar Handout
Recording: Feb 2024 NH AIM Recording
January 11, 2024 Webinar: Practical approaches to integrating mental health care from preconception to postpartum
Slides: Jan 2024 NH AIM ERASE MM Webinar Handout
Recording: Jan 2024 NH AIM Webinar Recording
TO VIEW PRIOR NH AIM WEBINARS: https://AIMERASEMM+Webinars/344078862
ERASE Maternal Mortality
CDC ERASE Maternal Mortality Project
Enhancing Reviews and Surveillance to Eliminate Maternal Mortality
The Maternal & Child Health Division of DHHS is working in partnership with NNEPQIN and other state teams and health systems to align national, state, and hospital level quality improvement efforts. Together we will utilize AIM’s framework and structure to improve maternal care and outcomes. The implementation of AIM bundles is central to our work on ERASE MM.
- This funding directly supports agencies and organizations that coordinate and manage Maternal Mortality Review Committees to identify, review, and characterize maternal deaths; and identify prevention opportunities
- Facilitate an understanding of the drivers of maternal mortality and complications of pregnancy and better understand the associated disparities.
- Determine what interventions at patient, provider, facility, system, and community levels will have the most effect.
- Inform the implementation of initiatives in the right places for families and communities who need them most.
AIM/ERASE Maternal Mortality Monthly Webinars
Held the 2nd Thursday of each month from 12 – 1PM
FLYER FOR JANUARY – JUNE 2025 NH AIM/ERASE MM WEBINARS: FINAL 2025 NH AIM Webinars Flyer
2025 WEBINARS:
May 8, 2025 Webinar: “Team debrief after an unexpected event: Support team and patient well-being“
Slides: May 2025 AIM slides
Recording for CE Credit: May 2025 NH AIM/ERASE Maternal Mortality Webinar Series – Team debrief after an unexpected event: Support team and patient well-being
April 10, 2025 Webinar: “Patient Perspectives on Supports and Services: What Works and What’s Needed”
Slides: April 2025 AIM slides
Recording for CE Credit: April 2025 NH AIM/ERASE Maternal Mortality Webinar Series – Patient Perspectives on Supports and Services: What’s Needed and What Works
March 13, 2025 Webinar: “Creating a community-wide approach to perinatal mental health”
Slides: 3.13.25 NH AIM ERASE MM Handout
Recording for CE Credit: https://dh.cloud-cme.com/course/courseoverview?P=0&EID=153023
February 13, 2025 Webinar: “From screening to action: setting the stage for an honest patient discussion”
Slides: 01272025 February 2025 AIM slides
Recording: February 2025 NH AIM ERASE Maternal Mortality Webinar Recording
For viewing for CE Credit: https://dh.cloud-cme.com/course/courseoverview?P=0&EID=153011
January 9, 2025 Webinar: “Clinical pearls to help address common barriers in providing mental health care”
Slides: 1.9.25 NH AIM ERASE MM Webinar Handout
Recording: January 2025 NH AIM/ERASE MM Recording
For viewing for CE Credit: https://dh.cloud-cme.com/course/courseoverview?P=0&EID=148950
2024 WEBINARS:
December 12, 2024 Webinar: “The importance of improving our birth certificate data collection.”
Slides: December AIM slides FINAL handout
Recording: December+2024+NH+AIMERASE+Maternal+Mortality+Webinar Recording
November 14, 2024 Webinar: “A multidisciplinary team approach to more effective discharge planning.”
Slides: November AIM ERASE webinar slide handout
Recording: November 2024 NH AIMERASE Recording
October 10, 2024 Webinar: “Creating comprehensive postpartum support in these challenging times.”
Slides: 10.10.24 NH AIM ERASE MM Webinar Handout
Recording: October 2024 NH AIMERASE Recording
September 12, 2024 Webinar: “Creating comprehensive postpartum support in these challenging times.”
Slides: September 2024 NH AIM Webinar Handout
Recording: September 2024 NH AIM Recording
August 8, 2024 Webinar: Why a comprehensive SDoH assessment improves your ability to address mental health concerns.
Slides: August 2024 NH AIM Webinar Handout
Recording: August 2024 NH AIM Recording
No July 2024 Webinar
June 13, 2024 Webinar: How to find the right consult when you have a client that needs a higher level of care
Slides: June 2024 NH AIM Webinar Handout
Recording: June 2024 NH AIM Recording
May 9, 2024 Webinar: How to provide appropriate mental health treatment in your community to meet your patients’ needs
Slides: May 2024 NH AIM Webinar Handout
Recording: May 2024 NH AIM Recording
April 11, 2024 Webinar: Utilizing the Plan of Safe and Supportive Care (POSC) to demonstrate patient strengths and link them with community based resources
Slides: April 2024 NH AIM ERASE MM Webinar Handout
Recording: April 2024 NH AIM Recording
March 14, 2024 Webinar: What does patient centered mental health care really look like?
Slides: March 2024 NH AIM Webinar Handout
Recording: March 2024 NH AIM Recording
February 8, 2024 Webinar: Creating a process that ensures a positive screen is addressed appropriately
Slides: Feb 2024 NH AIM ERASE Maternal Mortality Webinar Handout
Recording: Feb 2024 NH AIM Recording
January 11, 2024 Webinar: Practical approaches to integrating mental health care from preconception to postpartum
Slides: Jan 2024 NH AIM ERASE MM Webinar Handout
Recording: Jan 2024 NH AIM Webinar Recording
TO VIEW PRIOR NH AIM WEBINARS: https://AIMERASEMM+Webinars/344078862
New Hampshire Maternal Mortality Review Process
The NH MMRC conducts comprehensive and multidisciplinary reviews of maternal deaths, identifies contributing factors associated with these deaths, and makes actionable recommendations to improve health outcomes for pregnant and postpartum New Hampshire women. This work is done in partnership with the NH Department of Health and Human Services and supported by the CDC Enhancing Reviews and Surveillance to Eliminate Maternal Mortality program (ERASE-MM).
Link to NH POSC Website Resources: NH Plans of Safe Care check out the Pregnant and Parenting Services and Supports link and map.
New Hampshire Maternal Mortality Legislation (Enacted in January 2010, Section 132:29): NH Maternal Mortality Legislation
2024 Annual MM Report to NH DHHS Legislative Oversight Committee:
Maternal Mortality Report 2024 updated 04072025_FINAL VERSION
2023 Annual MM report to NH DHHS Legislative Oversight Committee:
2023 Annual Report on Maternal Mortality_Revised
2022 Annual MM report to NH DHHS Legislative Oversight Committee:
2022 Annual New Hampshire Report on Maternal Mortality FINAL
2021 Annual MM report to NH DHHS Legislative Oversight Committee:
2021 Annual New Hampshire Report on Maternal Mortality FINAL
2020 Annual MM report to NH DHHS Legislative Oversight Committee:
2020 Annual New Hampshire Report on Maternal Mortality FINAL 10 21 2020
NH MMRC Infographics:
Overview of NH MMRC Infographic 9-27-22 (003)
Suicide MM Infographic 9-27-22
Cardiac MM Infographic 9-27-22
NH MMRC Recommendations:
Key Data on Maternal Mortality in New Hampshire, 2023:
Summary of NH MMRC Recommendations
NH MMRC Decision on Death Preventability of Pregnancy-Related Deaths, 2019-2023
2018 Case Recommendations
Recommendations -Women of Childbearing Age:
- Enhance outreach to homeless individuals, prioritizing access to women’s services
- Promote standard management of patients with warning signs for substance misuse (ex- early refills), including face to face assessment, screening for presence of substance use disorders, and linkage to SUD treatment services
Recommendations -Prenatal and Post-Partum Care:
- Provide education to healthcare teams to reduce stigma against people who use substances
- Develop statewide provider education materials about hazards of co-prescribing benzodiazepines and opioid agonist medications
- Promote warm handoff from PCP to OB to facilitate engagement in prenatal care
Recommendations- Education for Providers
- Introduce assessment of social determinants needs, case management, and linkage to services directly from ED for patients with substance use disorder (SUD)-related complaints
- Standardize perinatal education for women with OUD about increased risk for overdose after period of abstinence
- Provide naloxone kits at discharge from inpatient stay; standardize postpartum discharge instructions
Past Recommendations Relevant to 2018 Cases
Recommendations – Pregnant Women with History of Substance Use Disorder:
- Harm reduction education for all pregnant patients with a substance use disorder
- Provider education on SHOUT as used in the “Zero Suicide” approach.
- Social workers/ medical personnel utilize immediate access to treatment for SUD using 211
- Provider and patient education about benzodiazepine/ opioid interaction.
Example: Reference information in the Greater Manchester Mental Health brochure
- Promote use of the Northern New England Perinatal Quality Improvement Network’s (NNEPQIN) Substance Use Guidelines.
Example: Consider echocardiogram for patients with injection drug related infection
- Pregnant women who are incarcerated received Medicated Assisted Treatment (MAT)
- Planning and collaboration between prison and community providers for pregnant patients around post- release treatment transition
Recommendations –Women in Recovery in Postpartum Period
- Prioritize keeping mother and baby together in safe environment for both, rather than separation/foster placement.
- Provide access to residential treatment which accepts children as an alternative to separation/foster placement for vulnerable women with complex dual diagnosis
- Provide access to higher level of care (residential care which accepts children) for women who are struggling with complex co-occurring disorders
Recommendations –Public Education
- Provide public education re: importance of prenatal care especially for women who use substances
- Provide public education re: importance of engaging in treatment for SUD for pregnant women
NH Maternal Mortality Review Committee
Clinicians and Clinical Quality Improvement:
- Perinatal Social Worker, Catholic Medical Center
- OB/GYN Medical Director Women and Children’s Services – Concord Hospital
- Director, Women’s & Children’s Services, Concord Hospital
- Maternal Fetal Medicine Physician – Dartmouth Hitchcock Medical Center
- Psychiatrist and Addiction Medicine Physician – Dartmouth Hitchcock Medical Center
- Psychiatry resident, Geisel School of Medicine/Dartmouth Health
- Obstetrical Anesthesiologist, Dartmouth Hitchcock Medical Center
- Certified Nurse Midwife & Executive Director, Dartmouth Population Health NNEPQIN/NH PQC
- Senior Quality and Safety Specialist, Dartmouth Population Health
- Perinatal Outreach Nurse and NH MMRC Abstractor and Coordinator, Dartmouth Population Health
- Perinatal Outreach Nurse, NNEPQIN, Dartmouth Population Health
- Chair, NH AWHONN Director – The Family Center, Center for Reproductive Care & Maternal- Fetal Medicine, Exeter Hospital
- Nurse Manager, Labor & Delivery Unit – Elliot Hospital
- Women’s Health Psychiatric-Mental Health Nurse Practitioner, Hope on Haven Hill
- Chair of the NH Chapter of ACOG & Obstetrician/ Gynecologist – SolutionHealth
- Chair, NH ACNM & Nursing Practice Specialist Wentworth Douglass Hospital
Substance use disorder, mental health, lived experience, and community health:
- Certified Recovery Coach, Dartmouth Hitchcock Population Health
- Community Health Worker, NH Medicaid Maternal Opioid Misuse Grant Program, Elliot Hospital
- Director, Hope on Haven Hill
- Director of Quality Improvement, Mental Health Center of Greater Manchester
- Vice President of Quality Improvement, NH Foundation for Healthy Communities
State Agencies:
- Chief Forensic Investigator and Deputy Chief Medical Examiner, NH Office of the Chief Medical Examiner
- Maternal and Child Health Section Administrator/Title V Director, NH Department of Health and Human Services
- Maternal and Child Health Epidemiologist, Maternal and Child Health Section, Bureau of Family Health and Nutrition NH Department of Health and Human Services
- Perinatal Nurse Consultant, Maternal and Child Health Section, Bureau of Family Health and Nutrition, NH Department of Health and Human Services
- Director, Bureau of Program Quality, Division of Program Quality and Integrity, NH Department of Health and Human Services
- Overdose Response Strategist, New England High Intensity Drug Trafficking Area (HIDTA)
- NH Bureau of Drug and Alcohol Services, NH Department of Health and Human Services
- Nurse Coordinator, NH Correctional Facility for Women
- Field Administrator, Child Protection, Division of Children Youth and Families
For questions or additional information, please feel free to contact us:
NNEPQIN@hitchcock.org or 603-653-6898
Resources
New Hampshire Perinatal Quality Collaborative Urgent Maternal Warning Signs: https://nhpqc.org/urgent-maternal-warning-signs
Grief and Loss Support: https://whatsyourgrief.com/
Hear Her Campaign, CDC: https://www.cdc.gov/hearher/index.html
National Alliance on Mental Illness, New Hampshire: https://www.naminh.org/
NH Mom Hub: The NH Mom Hub Connects mothers and healthcare providers to compassionate, evidence-based mental health support.
https://www.hopeonhavenhill.org/momhub/
National Maternal Mental Health Hotline: Text of call 1-833-TLC-MAMA 24/7 https://mchb.hrsa.gov/programs-impact/national-maternal-mental-health-hotline
Postpartum Support International:
For Moms, Partners, and Families: Call or Text our HelpLine 1-800-944-4773 (4PPD) #1 En Español or #2 English; Text in English: 800-944-4773; Text en Español: 971-203-7773
For providers: PSI provider directory, Perinatal Psychiatric Consult Line, and Trainings. https://psichapters.com/nh/#programs
Suicide Prevention Resources:
SUICIDE AND CRISIS LIFELINE and NH RAPID RESPONSE:
If you or someone you know is experiencing mental health symptoms, suicidal thoughts, substance use or other behavioral health concerns, we offer access to trained staff available 24/7 to listen, support and provide the guidance you need without judgment.
https://www.dhhs.nh.gov/programs-services/health-care/behavioral-health/strong-granite
For suicide loss survivors: https://theconnectprogram.org/find-support/coping-with-suicide-loss/ [theconnectprogram.org]
Free training for physicians to talk with families about firearms and safety in the home:
For additional information and support, please contact:
NAMI NH: Home – NAMI NH
NAMI NH Information & Resource Line: 1-800-242-6264
NAMI NH Contact: 603-225-5359 | info@naminh.org