ANMC recognized for helping reduce severe complications for pregnant Alaskans with high blood pressureJune 22, 2021
Over the past two years, the Alaska Perinatal Quality Collaborative (AKPQC) partnered with the national Alliance for Innovation on Maternal Health (AIM) Program to implement best practices to improve the outcomes for pregnant Alaskans with high blood pressure. The AKPQC recently reported the collaborative has helped to lead a 28% reduction in severe complications associated with high blood pressure during pregnancy.
High blood pressure during pregnancy is on the rise in Alaska, with high blood pressure disorders contributing to two out of the six pregnancy-related deaths in Alaska during 2012-16. In 2018, nearly one in 20 pregnant persons across Alaska were diagnosed with preeclampsia— a disorder characterized by high blood pressure and signs of damage to other organ systems. Among those births, over one in 10 experienced a severe complication.
To address this critical need, the AKPQC Hypertension in Pregnancy Initiative engaged six Alaska hospitals in a collaborative quality improvement effort to reduce hypertension-related severe maternal morbidity (SMM). The participating hospitals— Alaska Native Medical Center, Alaska Regional Hospital, Bartlett Regional Hospital, Fairbanks Memorial Hospital, The Children’s Hospital at Providence and Yukon-Kuskokwim Health Corporation— implemented protocols and best practices for timely recognition, treatment, and follow-up for patients who had severe hypertension during pregnancy and their postpartum period.
To make these strategic improvements, ANMC established additional training for providers and nursing staff as well as established systems for supporting patients, families and staff following a severe maternal event. Dr. Christina Rodriguez and Dr. Sarah Truitt and led this effort at ANMC, with considerable support and work from the inpatient obstetrics nursing team.
This collaborative received behind-the-scenes support from ANTHC Quality and Business Intelligence Departments and the Learning and Development Center at Southcentral Foundation. These teams worked to develop education for providers and nurses, developed an electronic tool to pull the data, validated that data, and then worked to submit the data to the state.
“This was truly an interdisciplinary campus-wide collaboration,” said Dr. Matt Hirschfeld, ANMC Maternal Child Health Medical Director. “It was a successful team endeavor between physicians, midwives, nurses, Quality, Business Intelligence and the Learning Center.”
Due to the significant efforts by our obstetric leadership and staff in this project, ANMC met or exceeded several targets for quality care, earning “Gold Recognition” from the State of Alaska, the highest level of achievement.
“Recognition and rapid treatment of severely elevated blood pressures in pregnant people can decrease the chance of complications, such as maternal stroke or brain bleed,” said Dr. Christina Rodriguez, Obstetrics and Gynecology Specialist in ANMC’s Maternal Fetal Medicine and the physician clinical lead of this initiative. “This is one component of a larger effort to ensure the safety of Alaska moms and babies.”
As a result of this initiative and the support of participating hospitals, the AKPQC exceeded its goal by reducing the rate of SMM among people with preeclampsia by 28% from 2018 to 2020. The rate of SMM among preeclampsia cases in 2020 was 7.4%, the lowest rate in the most recent five years.
“In addition to our recent severe hypertension initiative, the ANMC Obstetrics team of nurses, nurse midwives and physicians have focused heavily on obstetric safety since 2016, which includes our postpartum hemorrhage improvement and OB simulations program,” said Dr. Sarah Truitt, Service Center and Inpatient Medical Director for Obstetrics and Gynecology at ANMC. “Now, with the support of AIM and our statewide collaboration with other hospitals, we are able to benefit from data support as well as share and learn how to best implement obstetric care improvement.”
The long-term goal of the AKPQC is to eliminate preventable perinatal morbidity and mortality in Alaska. With considerable support and work from the inpatient obstetrics nursing team and a continued focus in these areas, ANMC will continue to lead the way to better health and wellness for our patients and their families.