Central Ohio Hospitals’ Collaborative Infant Mortality Efforts CMHA, 11-30-17

Scope of the problem

Scope of the problem

Place matters

Timeline of Activities GCIMTF Report Issued June 2014; Lead Entities assigned to carry out the work 2015 Work: Early elective deliveries Safe sleep 2016 Work: Very low birth weight infants 2017 Work: Medical Legal Partnership Tobacco cessation

2015 IM Work Early Elective Deliveries Establish a community standard and monitor performance, by hospital, to reduce early elective deliveries. Develop and have adopted by each adult hospital system standards aimed at reducing the number of elective deliveries. Hospitals submit on a quarterly basis the number of elective deliveries performed. Provide education in prenatal clinics and to local OBs on the importance of delivering as close to 40 weeks as possible.

EED Community Standards Sets community standard of 3% for EEDs Calls for education of pregnant women in hospital-based clinics

2014 Data

Provider, Community Education Flyer created to educate moms Flyer also sent to local OBs with letter from the COHC communicating new community standards

Results Community Goal set in 2015: 3.0% FY 2016 EED Aggregate EED Rate: 0.58%

Feb. 15: Hospitals performed monthly audits of safe sleep practices 2015 IM Work Safe Sleep Feb. 15: Hospitals performed monthly audits of safe sleep practices Audits show items in crib as an area for improvement

Provider Education Educational campaign conducted July thru Dec 2015 Aimed at Front-line providers

Results Campaign 2017 Q2 2017 results: 95.2% of cribs bare

Patient Education September 2016: Hospitals show video to all moms/parents who deliver Safe sleep Breastfeeding Shaken baby

Visitor Education December 2016: Hospitals display educational materials in maternity visitor waiting areas

Very Low Birth Weight Infants COHC Board Approved Community Standards in December 2016: Ensure that VLBW newborns are cared for in facilities that have consistently high volumes of these patients. System specific plans for meeting objectives took effect January 2017.

Results

2017 IM Work Medical Legal Partnership What is a Medical Legal Partnership? A Medical Legal Partnership (MLP) is a collaborative approach that brings legal aid services into the healthcare setting to address the social determinants of health among vulnerable populations. The National Center for Medical-Legal Partnership reports that MLPs have been established in 291 health care institutions in 41 states.

Medical Legal Partnership One-year pilot project: each hospital system has identified a prenatal clinic within their system to participate in the MLP program. Mount Carmel St. Ann’s Prenatal Clinic Nationwide Children’s Teen Pregnancy Clinic OhioHealth Wellness on Wheels (WOW) OSU Wexner Medical Center McCampbell Hall Prenatal Clinic Step One is also participating

MLP Screening and Referral Each clinic has adopt a high-risk screening tool, which is used by clinic intake staff to identify when a legal intervention may be appropriate. Each clinic has developed a referral system to send cases to an MLP attorney, who follow ups with the individual patient. An estimated 250 pregnant and postpartum women will receive access to a range of legal services.

Results MLP Referrals

Results MLP client story: Yasmin was referred to Legal Aid through the MLP because she was pregnant and her water had been shut off after her landlord passed away. After a week without water, Yasmin was prepared to pay the bill, but was unable to pay because the property was still in her landlord’s name. Legal Aid investigated the property and provided Yasmin with advice. Her water was restored.

2017 IM Work Tobacco Cessation Pilot project to strengthen hospitals’ tobacco cessation efforts Using 5 A Model for Treating Tobacco Use and Dependence (the first 3 As) Pilot will begin Jan. 1 at: Mount Carmel West Doctors OSU Main NICU