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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

The number of near misses for every maternal death.

80%

The percentage of patients with severe maternal hypertension treated within 60 minutes by October 2017 of the ILPQC Severe Maternal Hypertension Initiative.

50%

The percentage decrease in the severe maternal morbidity rate among women experiencing hypertension at delivery between 2015 and 2017, concurrent with the ILPQC initaitive.

Working to reduce severe maternal morbidity in women with severe range hypertension

Hypertensive disorders of pregnancy are a leading case of maternal mortality and morbidity. The severe maternal hypertension initiative launched in January 2016 with over 100 hospital teams participating. Hospital teams worked to improve outcomes through increased use of appropriate medical management of severe hypertension, debriefs, and discharge education and follow-up with new onset severe maternal hypertension cases. Initiative goals were achieved in October 2017 and hypertension teams transitioned to sustainability in January 2018.

Objectives:

  • 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.
  • 2.
    Increase the proportion of patients with severe maternal hypertension treated within 60 minutes to 80%
  • 3.
    Increase to 80% the proportion of patients who receive appropriate discharge education and follow-up appointments within 7-10 days post-discharge
  • 4.
    Increase to 50% the proportion of severe maternal hypertension cases with a debrief

Webinars

2016 Webinars

Illinois Maternal Hypertension OB Teams Calls

2017 Webinars

2018 – 2019 Webinars

Toolkit

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.

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:

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)

Data Resources

Other Resources

11 Steps to Getting Started with the Maternal Hypertension Initiative

Illinois Maternal Hypertension Initiative Comprehensive Slide Set

Illinois Maternal Hypertension Initiative Comprehensive Slide Set

ACOG DII (New York) Severe Hypertension in Pregnancy Clinical Education Slide Set

ACOG DII (New York) Severe Hypertension in Pregnancy Clinical Education Slide Set

ACOG Hypertension in Pregnancy Executive Summary

ACOG Hypertension in Pregnancy Executive Summary

AIM Bundle Readiness Resources: Checklists

AIM Bundle Recognition & Prevention Resources: Early Recognition and Patient Education

Protocols and Draft Order Sets

Patient Communication & Education

AIM Bundle Response Resources: Treatment Algorithms

Algorithms for Treatment

AIM Bundle Reporting/Systems Learning Resources: Drills, Debriefs, & Simulations

Simulation and Drills

ACOG DII (New York) Eclampsia Scenario

Briefs, Debriefs, and Huddles



Team Communication
**Key Resource
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.