Severe Maternal Hypertension
87.7
The rate per 10,000 of severe maternal morbidity in Illinois in 2014; an increase from 79.8 in 2011.
50 to 100
80%
50%
Working to reduce severe maternal morbidity in women with severe range hypertension
Objectives:
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1.Reduce the rate of severe morbidities in women with severe preeclampsia, eclampsia, or preeclampsia superimposed on pre-existing hypertension by 20% over the course of the initiative.
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2.Increase the proportion of patients with severe maternal hypertension treated within 60 minutes to 80%
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3.Increase to 80% the proportion of patients who receive appropriate discharge education and follow-up appointments within 7-10 days post-discharge
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4.Increase to 50% the proportion of severe maternal hypertension cases with a debrief
Webinars
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2016 Webinars
- May 23, 2016: Illinois Maternal Hypertension Initiative Face-to-Face Collaborative Learning Session
- Storyboard Template
- May 2, 2016: Illinois Maternal Hypertension Initiative Kick-off Call
- Improving Health Care Response to Preeclampsia: A California Quality Improvement Toolkit – Larry Shields
- AIM HTN Bundle 101: Key Steps for Implementation – Nancy Peterson
- Accurate Blood Pressure Measurement: Strategies for Success – Nancy Peterson
Illinois Maternal Hypertension OB Teams Calls
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2017 Webinars
- May 18, 2017: Illinois Maternal Hypertension Initiative Face-to-Face Collaborative Learning Session
- January 23, 2017: Implementing Standard Order Sets, Protocols, & Checklists
- February 27, 2017: Implementing System for ID and Protocols for Measurement, Assessment, & Monitoring of BP
- March 27, 2017: Implementing System for Rapid Access to IV/PO Anti-hypertensive Medications
- April 24, 2017: Implementing System Patient Education & Discharge Follow-up
- June 26, 2017: Implementing provider / staff education and checklists across units
- July 24, 2017: Implementing Maternal Early Warning Systems for Early Recognition
- September 25, 2017: Sustainability and System Changes for Drills and Simulations
- October 23, 2017: Sustainability and System Changes for Compliance Monitoring
- November 27, 2017: Sustainability and System Changes
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2018 – 2019 Webinars
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Additional Recordings
Toolkit
- New Resources
- HTN Sustainability
- Engaging the Emergency Department
- Data Resources
- Other Resources
- 11 Steps to Getting Started with the Maternal Hypertension Initiative
- Illinois Maternal Hypertension Initiative Comprehensive Slide Set
- ACOG DII (New York) Severe Hypertension in Pregnancy Clinical Education Slide Set
- ACOG Hypertension in Pregnancy Executive Summary
- AIM Bundle Readiness Resources: Checklists
- AIM Bundle Recognition & Prevention Resources: Early Recognition and Patient Education
- AIM Bundle Response Resources: Treatment Algorithms
- AIM Bundle Reporting/Systems Learning Resources: Drills, Debriefs, & Simulations
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New Resources
AIM: The revised Severe Hypertension in Pregnancy patient safety bundle was released in June 2022. Additionally, the bundle revision process incorporated Respectful Care elements in a 5th R and throughout the rest of the bundle to ensure whole person, patient-centered, and trauma-informed care for every patient, in every clinical encounter.
Preeclampsia Foundation: The Cuff Project provide access to blood pressure measurement devices, economic hardship, or limited knowledge should not be barriers to home-based monitoring. Early detection of high blood pressure in pregnancy may improve outcomes. Every woman should be able to check her own blood pressure at home this problem and raises awareness of the importance of self-monitored blood pressure.
AIM E-Modules: Available through the AIM website, this training includes 5 modules ranging from 5 to 20 minutes long which totals approximately 1 hour. This includes a quiz and certificate which you can ask your staff to submit. AIM eModules are being updated on their website and will be re-added soon (8/15/2022 Update)
Education for Providers: The Alliance for Innovation on Maternal Health (AIM) released a short and concise webinar, “Treating Maternal Hypertension”, on the importance of treating ALL maternal hypertension in a timely manner. This webinar was recorded in February 2017 by Drs. James N. Martin, Jr. (Chairman of the ACOG/SMFM Task Force on Maternal Hypertension and Past President of ACOG), Laurence Shields (Dignity Health Care and CMQCC) and Maurice Druzin (Stanford University and CMQCC). The webcast and accompanying slides can be found here.
Maternal Mortality Rate Video and Interview: PBS Newshour recently collaborated with NPR and ProPublica to report on the rise in maternal mortality rate in the United States. You can find a link to the video and interview here.
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HTN Sustainability
We want all HTN teams to finish the initiative strong! All 2017 HTN data should be submitted by February 15, 2018. Tools for a successful transition to sustainability are below:
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Engaging the Emergency Department
Journal of Continuing Education in Nursing: Triage Decisions Involving Pregnancy-Capable Patients: Educational Deficits and Emergency Nurses’ Perceptions of Risk (2021)
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Data Resources
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Other Resources
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11 Steps to Getting Started with the Maternal Hypertension Initiative
- 11 Steps to Getting Started with the Maternal Hypertension Initiative
- ILPQC Maternal Hypertension Initiative Goal & Measures
- ILPQC Severe Hypertension One Page Data Form
- ILPQC Severe Hypertension Two Page Data Form: Bedside & Chart Abstraction
- Key Driver Diagram: Maternal Hypertension Initiative
- Severe Blood Pressure Need to Treat Flyer
- AIM Patient Safety Bundle Overview
- AIM Baseline Survey & Quality Improvement Checklist
- IHI Model for Improvement/PDSA Worksheet
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Illinois Maternal Hypertension Initiative Comprehensive Slide Set
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ACOG DII (New York) Severe Hypertension in Pregnancy Clinical Education Slide Set
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ACOG Hypertension in Pregnancy Executive Summary
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AIM Bundle Readiness Resources: Checklists
- Signs to Promote Awareness:
- Emergency Department Sign
- ‘Days Since Not Treated in 60 Minutes’
- Ghostbusters Slide
- M.E.O.W.S Information:
- Maternal Early Warning Criteria Article 2014
- MEOWS Scale & Scores
- Crawford Hospital MEOWS Policy
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AIM Bundle Recognition & Prevention Resources: Early Recognition and Patient Education
Protocols and Draft Order Sets
- ACOG DII (New York)
- ACOG DII (New York) Key Elements for the Management of Hypertensive Crisis in Pregnancy
- California Maternal Quality Care Collaborative
- CMQCC Accurate Blood Pressure Measurement
- CMQCC Preeclampsia Early Recognition Tool (PERT)
- CMQCC Consultation Triggers in Severe Preeclampsia
- CMQCC Proteinuria
- CMQCC Nursing Assessment Frequency
Patient Communication & Education
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AIM Bundle Response Resources: Treatment Algorithms
- ACOG Committee Opinion 623, Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy
- CMQCC Sample Preeclampsia/Elcampsia Medication Toolbox
- CMQCC Steps for Preparation, Storage, Ordering and Administration of Magnesium Sulfate
- ACOG Conservative Management of Preeclampsia
Algorithms for Treatment
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AIM Bundle Reporting/Systems Learning Resources: Drills, Debriefs, & Simulations
Simulation and DrillsACOG DII (New York) Eclampsia Scenario
Briefs, Debriefs, and Huddles
Team Communication
The following material is an example only and not meant to be prescriptive. The resources provided in this toolkit are for informational purposes only. The exclusion of a resource, program, or website does not reflect the quality of that resource, program or website. Note: websites and URLs are subject to change.