ArticleBMJ open quality2022
Implementation and outcomes of a system-wide women's health 'team goal' to reduce maternal morbidity for black women: a prospective quality improvement study.
Article in BMJ open quality, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Optimizing outpatient cervical ripening: A mixed-methods study identifying implementation drivers during a multisite, randomized trial.Pregnancy (Hoboken, N.J.) · 2026Article
- "It's a priority": a qualitative analysis of the implementation of a maternal equity safety bundle in Massachusetts.Implementation science communications · 2025Article
- Standardized protocol for labor induction: a type I hybrid effectiveness-implementation trial.Lancet regional health. Americas · 2025Article
- Trends in severe maternal morbidity following an institutional team goal strategy for disparity reduction.American journal of obstetrics & gynecology MFM · 2024Article
- Evaluation of Statewide Program to Reduce Cesarean Deliveries Among Nulliparous Individuals With Singleton Pregnancies at Term Gestation in Vertex Presentation.Obstetrics and gynecology · 2024Article
- Strategies to Promote Maternal Health Equity: The Role of Perinatal Quality Collaboratives.Obstetrics and gynecology · 2023Review
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Authors and funding
7 authors.
Funding
Abstract
objectiveIn response to the unacceptable racial disparities in US obstetric outcomes, our health system established a formal goal to reduce maternal morbidity for black women. Here, we describe our process for meeting this equity-focused goal in the context of diverse implementation climates at 5 inpatient sites. STUDY
designTo meet the system goal, we established a collaborative of multidisciplinary, site-based teams. The validated 18-question Implementation Climate Scale (ICS) was distributed to site clinicians at baseline. Sites focused on haemorrhage, performing case reviews of black women meeting morbidity criteria. Comparing cases by site, site-specific areas for improvement in haemorrhage risk assessment, prevention and management emerged. Evidence-based practices (EBPs) were then selected, tailored and implemented by site. Monthly system-wide team meetings included (1) metric tracking and (2) site presentations with discussions around barriers/facilitators to EBP implementation. Maternal morbidity rates among black women were compared the year before goal development (1 July 2019-30 June 2020) to the year after (1 July 2020-30 June 2021).
resultsMean ICS scores for inpatient obstetric units differed by site (p=0.005), with climates more supportive of implementation at urban/academic hospitals. In response to case reviews, sites reported implementing 2 to 8 EBPs to meet the goal. Despite different ICS scores, this process was associated with significant reductions in maternal morbidity for black women from pregoal to postgoal development overall and at sites 1, 2 and 3, with non-statistically significant reductions at sites 4 and 5 (overall: -29.4% reduction, p<0.001).
conclusionsA health system goal of reducing maternal morbidity for black women led to a data-driven, collaborative model for implementing site-tailored interventions. If health systems prioritise equity-focused goals, sites can be supported in implementing EBPs that improve care.
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