1. March of Dimes 39+ Weeks Quality Improvement Service Package
Keith Nash, March of Dimes Florida Chapter
Lori Reeves, MPH
March of Dimes East Region

2. Available at: marchofdimes.com
Elimination of Non-medically Indicated Deliveries Before 39 Weeks Toolkit
Available at: marchofdimes.com or
cmqcc.org

3. QI Service Package Grand Rounds Secure Web Based Data Portal Webinars
Hospital Recognition*
*For those hospitals that achieve clear QI implementation process points
Grand Rounds
Secure Web Based Data Portal
Webinars
Discount on educational materials
Access to “Experts in the Field”

4. QI Service Package Grand Rounds
A National Speakers Bureau in partnership with ACOG and AWHONN members to support hospital Grand Rounds
Trained experts in perinatal care and quality improvement 

5. Secure Web Based Data Portal
Data Portal Goals
To help each hospital monitor its own program effectiveness
To measure initiative’s overall effectiveness across hospitals

6. Secure Web Based Data Portal
Data Portal Reports
Monthly and quarterly reports detailing key indicators and outlining change from previous months both in tabular and graphic form
Reports will include hospital data and comparisons to aggregate data from other hospitals (without hospital identifiers).
Key indicators include the number and percent of early term (37 0/7 – 38 6/7) scheduled inductions and cesarean section deliveries that are non-medically indicated (elective).

7. Sample Hospital (SH)
Singleton Early Term Deliveries (37 0/7 through 38 6/7 weeks gestation)
January, 2012
Hospital
Cohort 11
Cohort 2
Scheduled Deliveries
Scheduled Inductions
Elective Scheduled Inductions
Measure 3: Percent of scheduled inductions that are elective
Scheduled Cesarean Deliveries
Elective Scheduled Cesareans
Measure 4: Percent of scheduled cesareans that are elective
Total Scheduled Deliveries (Inductions and Cesareans)
Elective Scheduled Deliveries
Measure 5: Percent of all scheduled deliveries that are elective
Total Deliveries (scheduled and unscheduled)
Measure 6: Percent of all deliveries that are elective
NICU Admissions after a Scheduled Elective Delivery
Measure 7: Percent of infants admitted to the NICU / special care nursery after a scheduled elective delivery
1 Cohorts will be defined to determine meaningful benchmarks.
An elective delivery is non-medically indicated.
Prepared by the March of Dimes Perinatal Data Center, 2011

8. QI Service Package (Cont’d)
 Webinars
Presented by content leaders from across the country.
Step-by-step toolkit implementation guidance will be provided via six minute archived Webinars entitled:
Overview of the <39 Weeks Problem and Toolkit Change Components
Outline Medical and Non-Medical Indications <39 Weeks
Data Collection – Baseline and Post Implementation
Establishing Physician & Nursing Leadership and a Medical Hard Stop
Building Consensus – Difficult Provider Q&A
Patient Education

9. QI Service Package (Cont’d)
March of Dimes educational materials for consumers/patients to support implementation, including: “Why the Last Weeks of Pregnancy Count” brochures, brain card flyer, and posters

10. Sample Materials Late preterm brain development flyer – consumer.
Late preterm brain development card- - provider.
“Why the last weeks of pregnancy count” brochure –consumer.
Late preterm brain development poster.
Poster of pregnant woman wearing “Healthy Babies are Worth the Wait”
t- shirt image and message identical to print ad.

11. Patient FAQs
Toolkit includes patient education resources, including FAQs:
Why do babies need time (at least 39 weeks)?
Why can scheduling an early birth be a problem?
What happens if my labor starts before 39 weeks?
When is it okay to have a scheduled delivery?
What is “early term delivery”? Can early delivery really hurt my baby?
What does “the cervix is not ready” mean?
Etc…

12. QI Service Package (Cont’d)
 Access to “Experts in the Field”
Access to a listserv that includes experts as well as providers and other hospitals participating in March of Dimes-supported QI initiatives (e.g., to ask questions, seek advice, share lessons learned, etc.)
Monthly “office hours”, which are live chats with national QI experts and providers (e.g., to ask questions, etc.)
Experts available on a rotational basis include:
Bryan Oshiro, MD
Donald Dudley, MD
Kathleen Rice Simpson, PhD, RNC, FAAN

13. Hospital Recognition March of Dimes plaque and banner for hospital
 Hospital QI Recognition as “participating in a March of Dimes 39+ Weeks Quality Improvement Initiative…” that includes:
March of Dimes plaque and banner for hospital
Listing on March of Dimes website (
Opportunity for co-branding on media campaign!
Banners also available for non-QISP hospitals that meet criteria

14. 2013 QISP Opportunities
March of Dimes is releasing an RFA in late September for an additional 100 hospitals in 2013
Applications accepted until mid-November
Another round of 100 hospitals will follow in 2014

15. Questions?
Contact Lori March of Dimes