1. Pre & Early Term Birth Learning Network Learning Session 1 Pre-work Insert Your State Name Here Infant Mortality CoIIN

2. Overview Complete the following slide deck as a team and have your MCH Director (or designee) return it to CoIIN@nichq.org by Wednesday, March 11 th. CoIIN@nichq.org Welcome How to maximize collaborative learning Breakthrough Series (BTS) Model Learning Sessions & Action Periods Purpose of Pre-work Pre-work Checklist Pre-work Activities Instructions outlined in this slide deck Glossary of Terms

3. Welcome to the Pre & Early Term Birth Learning Network! We are excited to welcome the 21 states that have selected to be part of the Pre & Early Term Birth Learning Network. This Learning Network aims to reduce preterm and early term births. In 2012, 1 out of every 9 babies born in the United States was preterm. This is almost 450,000 babies each year. Preterm births are a leading cause of death and disability, and early term births also contribute to increased risk of morbidity and mortality in infants. We look forward to the opportunity to learn together through collaboration, innovation, and quality improvement methods. Your expertise, experience, challenges, and wins will benefit so many others and the families that we aim to serve. Please consider this template as a tool to support your state efforts by breaking down activities into small, manageable pieces. Data Sources: Division of Reproductive Health, National Center for Chronic Disease Control Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC); The American College of Obstetricians and Gynecologists Committee on Obstetric Practice-The Society for Maternal–Fetal Medicine, Committee Opinion Number 561. *NOTE: The terms “states” and “a state” seen throughout the document refer to all 50 states and 9 jurisdictions.

4. Maximize Learning Through Collaboration Breakthrough Series (BTS) – A learning collaborative model that brings together teams from various sectors to learn about evidence-based theory and improvement in a focused topic area Learning Sessions & Action Periods – These are a major part of learning collaboratives, designed to bring *states together to learn from experts and colleagues through plenary sessions, small group meetings, and team time. States will have a chance to gather new information & ideas on the topic area and process improvement, which they will use to create detailed action plans. Pre-work – Supports state engagement and maximizes time and resources. States who actively participate in pre-work will: Build team cohesiveness Jump start improvement activities Maximize value and meaning during the learning sessions

5. What happens during the Learning Sessions? Learning Session 1 Get ideas Get Methods Identify areas for improvement & innovation Get Started! Test changes on a small scale Learning Session 2 Get more ideas Get better at methods Get a “stride” Test & implement changes Learning Session 3 Celebrate successes Get ready to sustain and spread Continue to hold the gain! During the first Learning Session, we will: Define the problem Discuss changes we can make to improve Introduce quality improvement methods Provide time for teams to develop a plan of action Project End Action Period 1Action Period 2 Action Period 3 Action Periods: Time for teams to take what they learned, identify areas for improvement, build connections, and start testing on a small scale Maximize Learning Through Collaboration

6. Pre-work ActivitiesSupporting Materials Individually, all Pre & Early Term Birth Learning Network members should:  Register for Learning Session 1  Complete Online Community Profile  Review Orientation Packet & Pre & Early Term Birth key documents  Pre & Early Term Birth LS1 RegistrationRegistration  Online Community WebsiteWebsite  Orientation PacketPacket  Pre & Early Term Birth Key Documents will be posted on the Online Community prior to the Learning SessionOnline Community Together, Pre & Early Term Birth Learning Network members should complete the following assignment by 03/11/15:  Complete this slide template as a team  MCH Director (or designee) to submit to Aviel Peaceman by 03/011/15 Aviel Peaceman  “How to Build Your Team” webinar slides & recordingrecording  Orientation PacketPacket  Pre & Early Term Birth Key Documents will be posted on the Online Community prior to the Learning SessionOnline Community Pre-work Checklist Questions? Contact us at CoIIN@nichq.orgCoIIN@nichq.org

7. Key Document Review Building Knowledge

8. Questions to Consider As a State Team While reviewing the key documents, keep the following questions in mind. Be prepared to share some/all responses at the learning session. 1.What driver(s) appeals to you most and why? 2.What initiatives/activities/efforts is your state already engaged in that you see within the driver diagram? Of those, do any of them need improvement? 3.What innovative initiative/activity/efforts is your state working on that you’d like to take to scale and share with others? 4.What challenges are you facing and hope this collaborative can help your state address? 5.Who from your state team will collect the Pre & Early Term Birth Learning Network specific data? 6.Do you have a process in place to ensure easy data collection? If yes, describe briefly. If no, what challenges do you anticipate needing additional TA on? 7.Is there a specific approach or change you have been eager to try, but haven’t had the support to test and implement?

9. Building Your Team

10. Instructions Building your Pre & Early Term Birth Learning Network state teams will take time, and we do not expect you to have all team members identified at this point. Use slides 13 – 21 to identify your Pre & Early Term Birth state and pilot team members: Pre & Early Term Birth Learning Network Team Members Pre & Early Term Birth Pilot Site(s) Team Members Stakeholders If you did not attend the “How to Build Your Team” webinar, you can reference the recording and slides below: Click here to listen to the recording Click here View slides hereslides here Questions? Contact us at CoIIN@nichq.orgCoIIN@nichq.org

11. Example of Infant Mortality CoIIN Organizational Chart Questions? Contact us at CoIIN@nichq.orgCoIIN@nichq.org Infant Mortality CoIIN State Team Pilot Site #1 Safe Sleep Learning Network State Team Smoking Cessation Learning Network State Team Pre & Early Term Birth Learning Network State Team Pre & Interconception Care State Team Perinatal Regionalization State Team Pilot Site #2 Pilot Site #1 Pilot Site #2 Pilot Site #1 Pilot Site #2 Pilot Site #1 Pilot Site #2 Pilot Site #1 Pilot Site #2

12. Example of Pre & Early Term Birth Learning Network State Team Representatives Questions? Contact us at CoIIN@nichq.orgCoIIN@nichq.org MCH Director State Health Official (SHO) MCH Epidemiologist Stakeholders Home Visiting State Program Coordinator Governor’s Office Representative Patient & Family Advocate Infant Mortality CoIIN State Team Patient & Family Advocates Pilot Team Lead CoIIN Coordinator Pharmacists OB Offices (physicians, nurses, front desk) Hospitals (physicians, nurses, schedulers) Sonographers Home visitors Pilot Site(s) Medicaid director Representatives from WIC, home visiting, child welfare, and injury prevention Pre & Early Term Birth State Leader Hospital Representative OB representative Pharmacy representative Community based organizations Pre & Early Term Birth Learning Network

13. Identify Your Pre & Early Term Birth Learning Network State Team Representatives Pre & Early Term Birth Learning Network Roles Names of State Team Representatives Title & Organization Team Lead Hospital / Clinic Representatives Family Representative Others? Put a * next to new team member names and complete the new team member registrationregistration Identify all team members o This is an opportunity to provide us with a revised team roster to ensure all team members are included in the CoIIN distribution list Put a * next to new team member names and complete the new team member registrationregistration

14. What other team members do you think need to be part of this Learning Network? What are the first steps your team can take to begin to engage them in your efforts? Identify one unique thing about your team: Pre & Early Term Birth Learning Network State Team Representatives

15. Identify Your Pre & Early Term Birth Learning Network Pilot Site Representatives Possible Roles within a Pilot SiteNames of Pilot Site Representatives Pilot Site Team Lead Data Lead Other Members? Identify your Pilot Sites (OPTIONAL): Put a * next to new team member names and complete the new team member registrationregistration If you have not begun thinking about pilot sites and have questions, highlight them here.

16. Pre & Early Term Birth Learning Network Pilot Site(s) What other groups do you feel need to be included? What questions do you have regarding engaging a pilot site?

17. Potential Stakeholders Faith Based Groups Families & Communities Managed Care Organizations Community groups Private & Public Sector partners Multi-professional providers & institutions

18. Identify Your Pre & Early Term Birth Learning Network Stakeholders Current StakeholdersHow are they involved? Put a * next to new team member names and complete the new team member registrationregistration

19. Pre & Early Term Birth Learning Network Stakeholders What other stakeholders does your team plan to engage? What are key action steps towards moving that plan forward? Consider partner organizations, both public and private.

20. Pre & Early Term Birth Learning Network Patient & Family Engagement How does your team plan on engaging families at the multiple levels of this work? Have you already begun to engage families? If so, how?

21. Addressing Disparities Do you have access to data to assess/identify disparities? How will your state continue or begin to address disparities in birth outcomes as it relates to Pre & Early Term Birth?

22. Developing an Aim Statement Tailoring the Pre & Early Term Birth Learning Network aim statement to your state

23. Instructions Use slide 25 to tailor your state’s Pre & Early Term Birth Learning Network aim statement – The overall Pre & Early Term Birth Learning Network aim statement can be viewed on the next slide – The key question is “What are you trying to accomplish?” Keep the following in mind when creating your state’s aim statement: – Your aim statement is a description of what your team hopes to accomplish for a specific patient population – It is specific, measurable, achievable, realistic and time bounded – It is aligned with other organizational goals, and all those involved in the improvement process should support it – It should be aligned to the overall Learning Network aim statement – Goals will be determined by each state based on focus areas and baseline data Questions? Contact us at CoIIN@nichq.orgCoIIN@nichq.org

24. Pre & Early Term Birth Overall Aim Statement By July 2016, reduce prevalence of preterm and early term singleton births. States will: 1.Decrease non-medically indicated births between 37 0/7 weeks of gestation through 38 6/7 weeks of gestation to less than 5% 2.Increase the percent of pregnant women on Medicaid with a previous preterm birth who receive progesterone to 40% 3.Achieve or maintain equity in utilization of progesterone by race/ethnicity Goals will be determined by each state based on focus areas and baseline data

25. Insert State Team Pre & Early Term Birth Learning Network Aim Statement

26. Bright Spots & Potential Challenges

27. Instructions Use the next slide to identify your most successful change in Pre & Early Term Birth to date and expected challenges. Consider the following: – What successes, strengths, or expertise does your team have that you would be willing to share with other teams? This may include: Exciting innovations Community partnerships/ linkages Useful tools and resources How you overcame a significant barrier – What challenges or lessons learned have you experienced or anticipate encountering while moving your state’s Pre & Early Term Birth efforts forward? Be prepared to share some/all of your responses at the learning session Questions? Contact us at CoIIN@nichq.orgCoIIN@nichq.org

28. Bright Spots Most successful change in Pre & Early Term Birth to date and the data to support it:

29. Challenges & Lessons Learned Challenges or lessons learned have you experienced: Challenges you anticipate encountering while moving your state’s Pre & Early Term Birth efforts forward:

30. Next Steps

31. Data Collection Start thinking about data collection! After Learning Session One (LS1) teams will be asked to collect baseline data Questions to consider: – Can you easily access vital statistics and local data in your state? If not, what additional supports do you need to access your state’s vital statistics and local data? – Who on your team will manage the data collection? Vital statistics vs. pilot team(s) – How can your team improve access to data? Resources: Improving Systems, Access, & Utilization for Timely Provisional Vital Statistics – Part 1 RecordingRecording – Part 2 RecordingRecording Questions? Contact us at CoIIN@nichq.orgCoIIN@nichq.org

32. How Can We Support You? What support does your state anticipate needing at this time? What topics is your state interested in hearing more about? This can be within the Pre & Early Term Birth Learning Network or cross cutting themes that apply to Infant Mortality or Birth Inequities. What would your state like to hear from other states? The more specific the better!

33. Glossary of Terms TermsDefinition Breakthrough Series (BTS) A learning collaborative model that brings together teams from various sectors to learn about evidence-based theory and improvement in a focused topic area. Learning Sessions & Action Periods These are a major part of learning collaboratives, designed to bring states together to learn from experts and colleagues through plenary sessions, small group meetings, and team time. States will have a chance to gather new information & ideas on the topic area and process improvement, which they will use to create detailed action plans. Pre-work Allows states to assess current systems, supports state engagement and maximizes time and resources. Pilot Site A clinic, hospital, community organization or government program that tests and implements changes on the ground. Bright Spot Can refer to families, practices/hospitals, communities or states that have had success in improving safe sleep practices. Learning Network Convenes members from states and pilot sites to share, test, and implement ideas using the Breakthrough Series that will result in the reduction of infant mortality and the improvement of maternal and child health. COIN Stands for “Collaborative Innovation Network”. A subgroup of members from CoIIN Learning Networks that create, test, and improve an innovation. There are multiple COINs that can form and disband over time, not one network.

34. Submission Process Once you have completed this slide deck as a team, the MCH Director (or designee) can submit it to Aviel Peaceman at CoIIN@nichq.org by Wednesday, March 11 th. CoIIN@nichq.org You do not have to remove the instruction slides prior to submitting pre-work.