Alone, we can do so little. Together, we can do so much. Arkansas legislature has prioritized initiatives to improve health outcomes for mothers and their babies. This much-needed focus — Arkansas has the highest maternal mortality rate in the nation — will undoubtedly bring about change statewide. With support, structure, and collaborative expertise from the Arkansas Perinatal Quality Collaborative (ARPQC), birthing hospitals can shift from working independently from one another to joining a network of experts, policymakers, and teams working toward the same goal to improve maternal healthcare in the state.
What is the ARPQC?
The ARPQC is a state-based network of healthcare facilities and teams, policymakers, patients, and experts who work together to improve the quality of maternal healthcare in Arkansas. Dr. Jennifer Callaghan-Koru, associate professor in the College of Public Health at the University of Arkansas for Medical Sciences (UAMS), and Dr. William Greenfield, Medical Director at the Arkansas Department of Health (ADH) and professor of obstetrics and gynecology at UAMS co-founded ARPQC.
“State perinatal quality collaboratives are one of the national strategies proven to improve maternal health outcomes, and almost all states now have a functional PQC,” Dr. Callaghan-Koru said. “[Dr. Greenfield and I] worked together to secure funding for the ARPQC, applying for and receiving grants from the Centers for Disease Control and Prevention [CDC] and the Health Resources and Services Administration [HRSA].”
The ARPQC also collaborates with UAMS’s High-Risk Pregnancy program, combining quality improvement efforts under the coordination of the ARPQC. With the launch of the ARPQC, Arkansas now joins a national movement to prevent maternal morbidity and mortality and reduce disparities in maternal outcomes.
Data-Driven Support for Participating Hospitals
The ARPQC acts as a support system for 34 participating hospitals (all but one of the state’s birthing hospitals), offering data-driven, evidence-based initiatives to improve maternal and neonatal outcomes guided by quality improvement methods and implementation science. “As a learning collaborative, facilities participating in the ARPQC share their experiences to accelerate improvements and widespread implementation of best practices,” Dr. Callaghan-Koru said.
While the ARPQC primarily collaborates with facilities and providers to support healthcare quality improvement, they believe patients play an important role in their healthcare decision-making. “Patients should also be empowered to choose the best care for them and advocate for themselves during pregnancy, birth, and the postpartum period,” Dr. Callaghan-Koru said.
“We provide information to support patient decision-making on our website, including a map of birthing hospitals with detailed information about each hospital’s services and information sheets related to our initiatives.”
Specific supports the ARPQC offers to healthcare facilities and clinicians include:
- Evidence-based guidelines and tools. The ARPQC provides clinician education and tools based on recommendations from the Alliance for Innovation on Maternal Health (AIM) and other professional associations.
- Quality improvement support. The ARPQC’s quality improvement coaches guide participating teams on best practices for improving care. ARPQC’s four coaches are perinatal nurses from the UAMS high-risk pregnancy program. Meet the ARPQC’s coaching team and learn about how the ARPQC uses implementation science.
- Data for decision-making. The ARPQC works with facilities and ADH to collect and analyze data that supports quality improvement. Participating facilities can access the ARPQC data portal at their convenience.
Current Maternal Health Initiatives
ARPQC identifies healthcare processes that can be improved to better our state’s outcomes for mothers and babies. To select initiative topics, they look at data for the state and collect input from participating hospitals. ARPQC is currently focusing on two maternal health initiatives, with more to come in the near future.
“Our initiative with birthing hospitals is focused on preventing unnecessary cesarean births,” Dr. Callaghan-Koru said. “The initiative will run for another 12 months, and then we’ll start a new topic by July 2025. We are currently in the process of identifying that topic.”
“We also have a simulation training initiative for emergency departments to ensure they are prepared to identify and manage serious obstetric complications,” Dr. Callaghan-Koru added. The obstetric emergency preparedness initiative offers trainings on pregnancy-related hypertension and eclampsia. By the end of the year, they will also introduce trainings on precipitous birth and obstetric hemorrhage.
How to Participate in the ARPQC
To participate in the collaborative, birthing hospitals must sign a participation agreement, which formalizes their commitment to engage in collaborative quality improvement through the ARPQC. All participating hospitals attend monthly calls where they learn from experts and share their experiences, successes, and challenges.
“A real collaborative spirit has developed among the hospitals participating,” Dr. Callaghan-Koru added. “They share their innovative practices with each other and help solve each other’s challenges.”
Contact the ARPQC
To get in touch with the ARPQC, use the contact form on their website. Clinicians at birthing hospitals who are interested in getting involved can also connect with the nurse and physician champions for their facility — these are the unit leaders who work with the ARPQC to bring improvements to their hospital.
Arkansas birthing hospitals are working hard to implement initiatives to improve maternal health. Collaboration and support from the Arkansas Perinatal Quality Collaborative will allow participating hospitals to leverage evidence-based, data-driven care strategies for mothers and their babies. Having a team of experts, policymakers, and clinically experienced personnel to share challenges and identify solutions is instrumental in reducing maternal morbidity and mortality statewide.
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