This 2-Day course is designed to provide interactive in-depth skills and knowledge about Placenta Accreta Spectrum (PAS) to healthcare teams: sonographers, nurses, and physicians who care for pregnant patients and may encounter PAS.
Learn about postpartum preeclampsia in the emergency department
Family and Child Health Expertise Joins UTHealth Houston School of Public Health
Start Planning How to Integrate Social Determinants of Health at Your Hospital
More than 400 people attended the 2023 TCHMB Summit, which focused on Social Determinants of Health (SDoH) and its Impact on Maternal and Neonatal Outcomes. A majority of attendees reported that one of the major objectives was to take actionable quality improvement strategies back to hospitals, according to the post-summit survey.
During the summit, TCHMB provided an action plan and worksheet to get people thinking about the steps to make this happen. Even if you didn’t attend the summit, you can use these resources as a framework for building your plans to address SDoH at your hospital. It helps you list goals, milestones and think about target specific outcomes, as well as identify who in your organization can help you get there.
Be sure to check out the 2023 summit webpage for a copy of the slides if you need them to get your action plans started!
Download the summit pre-session worksheet.
Download the post-summit action plan.
Meet the New Quality Improvement Nurse at TCHMB!
TCHMB Welcomes Four New Executive Committee Members
Read more about why they are a good fit to lead TCHMB’s efforts for quality care, equity and safety for mothers and babies.
Vice-Chair of Executive Committee: Charleta Guillory, MD, MPH, FAAP
Professor of Pediatrics, Baylor College of Medicine
Why are you interested in serving as Vice Chair for TCHMB?
“As the Director of the Neonatal-Perinatal Public Health Program, and as immediate past Director of the Texas Children's Hospital Level II Nursery, I see firsthand, as a pediatrician and neonatologist, complications of prematurity, birth defects and metabolic disorders. These complications require many infants to be transferred into our center from across the state of Texas and beyond its borders.
I have always been an advocate to improve the health of mothers and babies and have recognized that vulnerable populations have poorer outcomes. I have dedicated my life, both professionally and personally, to decreasing infant mortality, improving infant and child health, and eliminating socio-economic, racial and ethnic disparity in maternal, infant and child health outcomes. Serving as Chair of the TCHMB is another opportunity to make an impact on the lives of Texas families. I bring to this committee a voice of experience and a voice of compassionate concern.”
Neonatal Committee Co-Chair: Gillian Gonzaba, NNP
Neonatal Nurse Practitioner, Associate Director for High Reliability/Patient Safety and Simulation, Pediatrix Medical Group, San Antonio
What do you hope to accomplish as Neonatal Co-Chair?
“I would like to work to improve access to care and diversity for all mothers across the state. With improved access to care, there is the potential for improved outcomes for our patients when they are born.”
New At-large EC Member: Jasmine Farrish CNM, MSN, MPH
Nurse Supervisor- Nurse Family Partnership University of Texas at Tyler Health Science Center
What strengths or unique perspectives do you bring to the Executive Committee?
“I have 10 years of maternal child experience in various settings mostly outside of the hospital setting. I believe the community perspective is important piece to serving the entire family in additional to addressing hospital policies. Serving families within the home as a nurse home visitor shed light on the importance of addressing the entire family unit in order to impact change.”
New At-large EC Member: Sonal Zambare, MD
Assistant Professor; Obstetric Anesthesiology, Baylor College of Medicine
What strengths or unique perspectives do you bring to the Executive Committee?
“As a fellowship trained anesthesiologist from a busy practice, I bring my experience in successfully managing many high risk, and complicated pregnant patients. I am the anesthesiologist on the MOM grant (a grant from CMS for helping pregnant patients with substance use disorders, especially opioids), which has broadened my reach to the community. I am the lead on establishing the Enhanced Recovery after Cesarean protocol at Ben Taub Hospital, which has been a successful program.”
Hospitals Are Moving the Needle on Data Collection
The Newborn Admission Temperature (NAT) Project aims to improve the proportion of newborn babies with normal temperatures. We completed more than one year of data collection and early this fall released example evidence-based guidelines that hospitals can choose to use.
The NAT project has also produced benefits for implementing future QI projects and initiatives. For example, we asked hospitals to rate the statement “Being part of the NAT project helps us better report data by race and ethnicity.”
The proportion of hospitals that reported that their participation in the NAT project is helping them improve reporting of data stratified by race and ethnicity increase over the course of the initiative. In the first two data reporting cycles, only about one third (33-38%) of hospitals agreed with this statement, compared to nearly half (47%) of hospitals by the most recent data reporting cycle. (Click here to view the graph.)
Looking at the critical factors and conditions (challenges or barriers) that ensure effective practices are carried out and sustained for future practices is part of implementation science and it is equally as important as improving health outcomes for several reasons:
Routinely reporting race/ethnicity through the NAT project might have a trickle-down effect as hospitals begin to build these processes within their own systems and projects; and
The NAT project is the first TCHMB project that has documented outcomes by race and ethnicity and has set the stage for future TCHMB projects to do the same. This is a strategy that cannot be understated given the disparities in maternal and neonatal outcomes in Texas.
Texas’ perinatal population is diverse and rapidly growing, and despite considerable improvement efforts, disparities in several key perinatal health indicators persist or have widened. Black mothers in Texas had higher rates of severe maternal mortality (SMM) than mothers of any other race or ethnic group over the past decade, and this disparity has widened since 2016.
High-quality, stratified data including race and ethnicity, at a minimum, can help reveal how different subpopulations are faring and track efforts to advance equity in health care and health outcomes. In this way, through its data collection process and through the participation of hospitals, the NAT project is breaking barriers while also working to eliminate disparities in perinatal health outcomes.
Read more about the new CDC grant that will work towards eliminating disparities in Texas.
DSHS Releases 2022 Morbidity and Mortality Report
The Texas Department of State Health Services released the 2022 Morbidity and Mortality Report, showing that obstetric hemorrhage was the leading cause of pregnancy-related death in Texas, with mental health second. The report shows racial disparities persist and discrimination contributed to 12% of pregnancy-related deaths in 2019.
Diving into Social Determinants of Health
It is common for patients to leave the hospital and not get prescriptions or health-related services post-discharge. These factors, some of which are external to the healthcare system, still affect a person’s health. Therefore, hospitals have begun addressing social determinants of health, also known as health-related social needs. Examples of social determinants of health include employment, transportation, and access to medicine and food. Social determinants of health make up 80% of the care that patients need for optimal health. Everyone has social determinants that affect their health, and for those who lack the resources to meet their needs, there are community organizations and programs to address these needs.
The theme of the 2023 Texas Collaborative for Health Mothers and Babies Summit is Social Determinants of Health and How They Impact Maternal and Neonatal Outcomes. Our aim is to provide examples from other Perinatal Quality Collaboratives, hospitals and partner organizations and programs to show that addressing social determinants of health can improve birth outcomes for mothers and babies, beyond the first year of birth. Hospitals are learning it is not enough to document needs or even supply a list of services. Some patients need navigators and advocates who can walk alongside them for a period. Therefore, some of the Summit sessions will include how and when to measure social needs; how to find partners to address social needs; how to refer patients in a meaningful way; and how to ensure or document how patients’ needs have been met, also known as closing the loop.
To learn more about social determinants of health, what your organization can do, and tools, visit the following websites:
https://www.aha.org/social-determinants-health/populationcommunity-health/community-partnerships - See article – Emerging Strategies to Ensure Access to Health Care Services – Social Determinants of Health
