OB Standing Committee Logic Model Short- and Long-Term Outcomes Resources Activities Outputs Short- and Long-Term Outcomes Impact Data analytic capabilities Logistic support Implementation resources Subject matter expertise Develop toolkit Put together expert panel of physicians, hospitals, stakeholders (ID stakeholders) Data collection, what to measure, pre/post, define data elements to report Explore areas of controversy and achieve consensus on key areas Explore distribution methods Way to develop and distribute toolkit Identify champions – have push out to their organizations Evaluation plan - create Determine model of implementation Toolkit in place Distribution in place Education of providers (medical community) # of toolkits distributed, # of providers educated Data reporting, Distribution of data through professional associations Publish results Short: S-Decrease in maternal morbidity due to hypertension S-Creation of toolkit; Long: L-Decrease in maternal mortality due to hypertension; S/L - Reduction in infant mortality; Reduction in infant morbidity; Increase appropriate use of antenatal steroids; Decrease perinatal mortality rate; L-Distribution/utilization of toolkit; Change in practice Sustained reduction of mortality/ morbidity Establish best practices related to maternal/fetal transport protocols

Neonatal Standing Committee Logic Model Short- and Long-Term Outcomes Resources Activities Outputs Short- and Long-Term Outcomes Impact Data: Availability of state data Other applicable data sets (HMO, Feds, Hospital) Benchmarks: Some hospitals may have low rates – who and why? Data dependent Practice plan models (Kaiser, St. David’s) Broad (MoD) Black box approach: Source of data remains anonymous; data translator Use of toolkit (possible webinar, etc.) Education at multiple levels (inpatient, outpatient, caretaker, parents, payers, politicians, state support systems such as WIC) Data collection: cost to MCO to provide these services as inpatient vs. outpatient, etc. Review existing models Determine/implement/create best models Review reimbursement/ payment model Toolkits: RN, MD, Hospital , private practitioner education Specific populations Participation in VON/CPQCC Education of families so they can be allies Reimbursement will need to be considered Short term: Decrease in hyperbilirubinemia, hypoglycemia, other clinical sequelae of PTB Data stratified to see where problems lie Decrease hospital readmission of preterm infant Long-term: Socioeconomic measures improve School performace improvement among PT school-age children Reduce overall healthcare costs Healthier babies Quality Properly managed patient (inpatient and outpatient) means decreased hospital cost Decreased cost to school system, parents Behavioral health improved=decreased cost and impact on families Increased patient satisfaction, therefore increased health plan satisfaction

Cont’d. Neonatal Standing Committee Logic Model Resources Activities Outputs Short- and Long-Term Outcomes Impact Best practice data (needs identifiers) Currently available toolkits Who will do all this work? Consultants for SMEs Data Resources: Kaiser, Pediatrix, CPQCC Need some source of money & help Funding Sources: MCO/Medicaid Increased self-efficacy (more competence and confidence in caring for the child) Increase the impact of breastfeeding at 3 & 6 months)

Neonatal Barriers No uniform Electronic Medical Record How to get info to providers after discharge Information exchange Getting access to needed de-identified health data Limit to what volunteers (EP) can do Health plans, Medicaid need to give money to support this, they will benefit Volunteers supported Workgroups, but need support like initial workgroups Don’t want to lose people because there’s no travel money Parent involvement

Neonatal Parking Lot Strong support statement for breastfeeding Suggest a SWOT analysis for the big group = Ongoing SWOT analysis: what accomplished, why/why not ID/Confirm individuals to be on this committee By working together, everyone from the patient on down benefits – everyone contributes to help the patient