Healthy Babies Initiative and National CoIIN Rollout
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1 Healthy Babies Initiative and National CoIIN Rollout David Lakey, MD Commissioner Texas Department of State Health Services ASTHO Annual Meeting September 10, 2014
2 Infant Mortality 2008 Preterm Birth 2008
3 Background & Key Developments Spring 2010: State health officials in South commit to regional effort to reduce infant mortality and prematurity Dec. 2010: Letter to Secretary Sebelius, meeting with HRSA Administrator Wakefield Oct. 2011: David Lakey, MD (TX) issues ASTHO s Healthy Babies President s Challenge Jan. 2012: HRSA Summit for Regions IV, VI Mar. 2012: ASTHO-March of Dimes Partnership Launch July 2012: HRSA Regions IV/VI Collaborative Improvement & Innovation Network (CoIIN) Mar. 2013: HRSA Summit for Region V and CoIIN Launch Oct. 2013: Region IV, V, and VI joint CoIIN Meeting July/Aug. 2014: National Roll Out of CoIIN: Regions I-III, VII-X, and Pacific Islands Infant Mortality Summits Oct. 2014: Region V Infant Mortality CoIIN Meeting
4 ASTHO March of Dimes Partnership March 2012: ASTHO/March of Dimes Partnership State/Territorial Pledge Virginia Apgar Award (8%) Franklin Delano Roosevelt Award (9.6%) MOD State Chapter/SHA Partnership Co-Branding of Healthy Babies are Worth the Wait Campaign MOD Materials and Tool kits
5 50 States Have Taken the Pledge Pledge to Reduce Prematurity by 8% by 2014 D.C. Puerto Rico Taken Pledge *as of Nov Virginia Apgar Award (8% Reduction) Franklin Delano Roosevelt Award (9.6% Prematurity Rate)
6 Possible Points for Intervention Maternal Health/ Prematurity Maternal Care Newborn Care Infant Health Preconception Health Health Behaviors Perinatal Care Prenatal Care High Risk Referral Obstetric Care Perinatal Management Neonatal Care Pediatric Surgery Safe Sleep Breast Feeding Injury Prevention 6 6
7 COIIN Design Common Strategies for Regions IV, V, and VI State Teams Strategy Team Supports Smoking cessation Interconception care State health officials MCH staff Medicaid staff Private partners (academic experts, March of Dimes, clinical providers, health plans, etc.) Average 7-15 people Strategy Leads (2-3 experts, including state officials) Data and/or Methods Experts Staff support (MCHB/HRSA plus CMS and partner organizations ASTHO, AMCHP, March of Dimes, CitymatCH) Early elective deliveries Social Determinants of Health Safe sleep Perinatal regionalization Supported by Contract Team of expertise in quality improvement 7
8 CoIIN National Rollout Infant Mortality Summits were held in July in Washington, D.C. and in August in Honolulu, HI Regions VII, VIII, IX, X Summit (July 21-22) Regions I, II, III Summit (July 24-25) Region IX Pacific Territory Summit (August 24-25) Next Steps: State teams are working to finalize their Infant Mortality Plans and Blueprints for Change Specific strategies that are addressed by CoIIN teams will be determined when state IM Plans are reviewed for common themes
9 State Examples GA MD Targeted interventions in six highrisk areas; EED declined more than 50% from Crib bumper pads were banned statewide beginning in June 2013 to promote safer sleep for infants OK 90% of state birthing hospitals participating = 81% decrease in total scheduled deliveries from Q through Q SC 43 birthing hospitals committed = 50% reduction in EED, publicprivate partnership saved >$6 million in Q1 2013
10 March of Dimes Support for Regions IV & VI Activities Summits or Key Stakeholder Meetings Areas of focus include: EED; Centering Pregnancy; Birth Spacing; Development of Perinatal Strategic Plan; Creation of a Perinatal Collaborative; Latest Evidence-based Practices; 17P; Data Multi-faceted Campaign on Smoking Cessation in Pregnancy Perinatal Quality Collaborative Development Population-based Survey of Maternal Behaviors and Experiences Activities to Promote Proper Use of 17P State(s) Arkansas, Georgia, New Mexico, North Carolina, Oklahoma, Texas, Tennessee South Carolina Mississippi Florida Louisiana
11 Since the launch of the Healthy Babies Initiative Partnerships leveraged Recognition/Incentive Awards developed Infant Mortality Plans developed Resources developed and obtained Policies changed Networks for sharing evidence-based and innovative practices established Babies Lives Saved!
12
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