Implementation Plan​

 

Background and Foundational Resources

• "ACOG Committee Opinion: Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period." This text has been withdrawn or is no longer available.

• AIM Severe Hypertension in Pregnancy Safety Bundle

• The Joint Commission New Standards for Perinatal Safety. The Joint Commission updated standards for perinatal care during the bundle implementation. Earlier standards are no longer available on the Joint Commission website.

 

Data Resources

• Alaska AIM Monthly Data Spreadsheet​

• Alaska AIM Data and Debrief Worksheet​

• AIM Data Center Login

• AIM Data Center User Guide

 

Quality Improvement Resources

• Institute for Health Care Improvement Quality Improvement Essentials Toolkit

• AIM Implement Quality Improvement Projects Toolkit

• Plan Do Study Act Cycle Worksheet​

 

March 2020: Resources to develop standard order sets, treatment protocols, and checklists for recognition and response to severe maternal hypertension

• Hypertensive Emergency Checklist (ACOG District II)

• Eclampsia Checklist (ACOG District II)

• Emergency Department Postpartum Preeclampsia Checklist (ACOG District II)

• ACOG Sample Order Sets Pocket Guide (Illinois PQC)

• Labetalol Treatment Algorithm (ACOG District II)

• Hydralazine Treatment Algorithm (ACOG District II)

• Oral Nifedipine Treatment Algorithm (ACOG District II)

• Hypertension Medication and Monitoring Order Sets (Bartlett Regional Hospital) 
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April 2020: Ensuring rapid access to IV and PO hypertensive medications

• Guidelines for treatment of severe hypertension (Alaska Native Medical Center or ANMC)​

• Nifedipine order set (ANMC)​

• Labetalol order set (ANMC)​

• Severe Hypertension in Pregnancy and ED  presentation by Sarah Truitt, MD and Leanne Komorowski, MD (ANMC)​

• Severe Hypertension in Pregnancy presentation by Neil Murphy, MD (ANMC)​

 

May 2020: Train providers and nurses on recognition and response to severe maternal hypertension and accurate blood pressure measurement

• AIM Severe Hypertension in Pregnancy E-Module Introduction

• AIM Severe Hypertension in Pregnancy E-Module Readiness

• AIM Severe Hypertension in Pregnancy E-Module Recognition

• AIM Severe Hypertension in Pregnancy E-Module Response

• AIM Severe Hypertension in Pregnancy E-Module Reporting

• AIM Treating Maternal Hypertension Webinar Recording (February 2017)

• AIM Treating Maternal Hypertension Webinar Slides (February 2017)

 

June 2020: Executing protocols to treat severe hypertension within 60 minutes

• Implementation of the AIM Hypertension Bundle presentation by Danette Schloeder (The Children’s Hospital at Providence)

 

July 2020: Ensure patient follow within 10 days for all patients with severe hypertension and within 72 hours for patients on medications

• Postpartum Hypertension Follow-up at ANMC by Tirza Cannon, OB/GYN

 

August 2020: Implement patient-centered education of pregnant people and their families on signs and symptoms of severe hypertension/preeclampsia

 

September 2020:  Establish a system to perform regular debriefs after all cases of severe hypertension

• California Maternal Quality Care Collaborative Preeclampsia Toolkit: Teamwork and Communication. Includes strategies for effective team communication and approaches to resolving conflicts.

• Pocket Guide: Team STEPPS. Includes definitions and checklists for briefs, debriefs, and huddles.

• Department of Defense Briefs and Huddles Toolkit. Includes a facilitation guide for training staff on briefs and huddles with videos and case study exercises. 

• Florida PQC Debriefing Following a Severe Incident in Pregnancy. Includes tips and promising practices for debriefs.

October 2020: Establish a process for multidisciplinary reviews of all cases of severe maternal morbidity 

• SMM Toolkit

• SMM Debrief Form

• SMM Review Form (short version)

• SMM Review Form (long version)

 

November 2020: Implement systems to identify pregnant and postpartum patients in all hospital departments

• Identifying and treating pregnant and postpartum patients in the ED by Danette Schloeder

• Emergency Care for Patients During Pregnancy and the Postpartum Period: Emergency Nurses Association and Association of Women’s Health, Obstetric and Neonatal Nurses Consensus Statement

• ACOG District II: Emergency Department Postpartum Preeclampsia Checklist

 

December 2020: Implement systems to support patient, families, and staff following a severe maternal event

• AIM Support after a Severe Maternal Event Safety Bundle

• Communication for Obstetric and Perinatal Events (COPE) Framework

• New Roles for Mental Health Professionals Before, During, and After Severe Maternal Events

 

AIM Hypertension Initiative Learning Sessions

• Standardized Severe Maternal Morbidity Review: Use of Teams, Tools, and Tracking Slides 11.18.20

• Standardized Severe Maternal Morbidity Review: Use of Teams, Tools, and Tracking Recording 11.18.20

• Addressing Psychological Impacts of Severe Maternal Events on Providers, Patients, and Families Slides (8/31/20)

• Addressing Psychological Impacts of Severe Maternal Events on Providers, Patients, and Families Recording (8/31/20)

• Management of Postpartum Hypertension/Preeclampsia Slides (2/20/20)

• AIM Hypertension Learning Session Recording (10/15/19)

• AIM Hypertension Learning Session Slides (10/15/19)

  • Topics: Case Study, Patient Education, Accurate BP measurement

• AIM Hypertension Learning Session Recording (8/5/19)

• AIM Hypertension Learning Session Slides (8/5/19)

  • Topics: Facility Story, AIM HTN Readiness domain, Timely treatment

• AIM Introductory Webinar Recording (3/19/19)

• AIM Introductory Webinar Slides (3/19/19)

 

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