The Alaska Perinatal Quality Collaborative launched the Substance Affected Pregnancies Initiative (SAPI) in September 2021 with seven participating hospitals. SAPI engaged hospitals in collaborative quality improvement following the Institute for Healthcare Improvement’s Breakthrough Series model.

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SAPI facilities implemented best practices in the care of pregnant people with substance use disorder and newborns exposed to substances following the below diagram and change package. This initiative is currently in sustainment.