Maternal Opioid Use Disorder
Accidental Poisoning, including Unintentional Prescription Drug-Related Deaths, is the Leading Cause of Pregnancy-Associated Deaths in Pennsylvania
(PA DOH Report, Pregnancy-Associated Deaths in Pennsylvania, 2013-2018)
The PA PQC was launched in April 2019 as an action arm of the Pennsylvania Maternal Mortality Review Committee (MMRC) to improve the identification of and care for pregnant and postpartum women with Opioid Use Disorder (OUD) and Opioid-exposed newborns. As of January 2021, the quality improvement projects of PA PQC hospital teams have led to improvements, such as a 34% increase in sites using a validated, self-report screen for substance use disorders (SUD) in pregnancy and a 32% increase in sites with clinical orders sets for maternal OUD.
 
Goals
  • Increase substance use disorder (SUD) screening, using validated screening tools, among pregnant individuals
  • Improve diagnosis of maternal OUD
  • Increase initiation in and continuation of Medication-Assisted Treatment (MAT) among pregnant and postpartum individuals
  • Increase engagement in prenatal and postpartum care
  • Create a safe environment by connecting the mom and baby dyad to wrap around supports prior to discharge
  • Increase engagement in home visitation services for mothers and infants exposed to opioids
  • Care for the mom and baby dyad for 15 months through well-child visits
Key Interventions
Get Involved

New PA PQC provider organizations and teams typically start with a quality improvement project on maternal OUD or NAS. As a result, the PA PQC has an ongoing open enrollment period for PA PQC provider teams to start a maternal OUD or NAS quality improvement project. The PA PQC encourages all PA PQC provider teams to continuously improve care for maternal OUD and NAS.

  1. Ensure your birth site is a member of the PA PQC (join here if your team is not yet involved in the PA PQC)
  2. Identify a multi-disciplinary OUD quality improvement team with outpatient and inpatient team representatives (please review the PA PQC Brief for the roles of core PA PQC team members)
  3. Contact your birth site’s PA PQC quality improvement coach or papqc@whamglobal.org for guidance on how to begin your birth site’s PA PQC OUD quality improvement project
Expectations

With guidance from your PA PQC quality improvement coach:

  • Further expand, develop, and structure your multi-disciplinary team
  • Organize monthly quality improvement team meetings to prioritize and adopt the PA PQC maternal OUD key interventions based on your current condition
  • Develop and implement a quality improvement plan and protocols with your team, making continuous improvements
  • Complete quarterly OUD surveys to track your team’s impact on the structure measures compared to your peers in the PA PQC
  • Submit aggregated numerators and denominators for the monthly PA PQC OUD process measures (SUD screening rates, OUD diagnosis rates, MAT initiation rates, and postpartum care rates) via the PA PQC data portal to track your improvement over time compared to your peers
  • Attend the quarterly PA PQC Learning Sessions
  • Provide a Quality Improvement Report Out, using the QI Report Out Template, prior to each quarterly PA PQC Learning Session
  • Attend the PA PQC Quality Improvement Collaborative Meetings for peer-to-peer learning around maternal OUD in-between the Learning Sessions
Resources

Maternal OUD Resources
(SUD screening tools, presentations, guidelines, toolkits)

Community Resources
(OUD PacMATs and COEs, SUD Single County Authorities, Family Resources)

Motivational Interviewing Resources