AIM Program | Moving Forward to End Preventable Maternal Mortality
This post is part of “Inequities in Maternal Mortality in the U.S.,” a blog series hosted by the MHTF.
These facts are a definite cause for pause:
- For every maternal death, there are 100 severe maternal complications that occur at/near childbirth
- Black women will experience 3-4x more severe maternal complications than white women
- The majority of maternal deaths are preventable
To tackle the rising maternal mortality and morbidity rates in the United States, the Maternal-Child Health Bureau (MCHB) has funded a national maternal safety and quality improvement initiative, known as the Alliance for Innovation on Maternal Health (AIM) Program. The overarching goals of the AIM Program are to prevent 1,000 maternal deaths and 100,000 severe maternal complications in the U.S. by the end of 2018. The AIM Program is a multidisciplinary and collaborative effort to reduce preventable maternal mortality and morbidity and is spearheaded by the American College of Obstetricians and Gynecologists (ACOG) in collaboration with a core partnership of professional provider and public health organizations, federal agencies and patient advocates.
The core objective of AIM is the development and implementation of maternal safety bundles. Maternal safety bundles, also known as patient safety bundles (free registration and login required), are sets of actionable maternity care best practices that have been proven to reduce preventable maternal mortality and morbidity. In addition to these bundles, AIM utilizes ‘lessons learned’ from state maternal mortality review committees (MMRCs) and state perinatal quality collaboratives (PQCs) to ensure consistent obstetric best practices are implemented in all birth facilities.
State MMRCs provide a systematic and multidisciplinary team approach to reviewing the causes, both biologic and systemic, of maternal deaths at the state level. The goal of the MMRC is to identify gaps in health services and make actionable recommendations to prevent future maternal deaths. PQCs serve a similar function and are comprised of perinatal care providers and public health professionals working to improve pregnancy outcomes by advancing evidence-based clinical practices and continuous quality improvement processes. MMRCs and PQCs function to improve public health surveillance of maternal health outcomes and the lessons learned from each have helped focus national efforts on creating a ‘culture of safety’, establishing consistent obstetric best practices and promoting data-driven quality improvement efforts in maternity care.
These lessons learned have also led to the discovery of innovative strategies that are improving real-time public health surveillance of pregnancy-related and maternal health outcomes. To ensure states and birth facilities participating in AIM can utilize real-time data to drive their maternal safety and quality improvement efforts, AIM has aligned process, structure and outcome measures with each maternal safety bundle (see AIM Data Collection Plan) and developed a secure data portal for birth facilities to report to on a quarterly basis. Birth facilities, in return, can access their data to drive their continuous quality improvement efforts and utilize their local resources more effectively.
In addition to promoting the implementation of maternal safety bundles in all U.S. birth facilities, AIM will begin moving forward in 2016 to reduce peripartum racial disparities in access, quality and outcomes of care within birth facilities. The Reduction of Peripartum Racial Disparities maternal safety bundle is currently under development by a team of multidisciplinary women’s health clinicians, public health professionals and patient advocates. The initial focus of this bundle workgroup is to consider African American pregnant women as being at elevated risk for maternal morbidity events and establish a facility-wide culture of hypervigilance and enhanced patient communication. Moving forward, AIM is committed to effectively addressing the pressing challenges facing the U.S. maternity care system, while aligning its efforts with the Sustainable Development Goals (SDGs) to join the global effort of ending preventable maternal mortality (EPMM) by creating domestic and global equity for all mothers.