The PA PQC hospitals are looking for guidance around Substance Use Screening and performing this in a trauma informed way. Additionally, they are moving along with their screening processes and want to know how they can connect to community based organizations to assist patients using Medication Assisted Treatment. Breastfeeding is often not recommended for patients with Substance Use Disorder without the knowledge of the full details on what is appropriate. The hospitals are hesitant to use Long Acting Reversible Contraceptive devices, like an IUD, because they are concerned about explusion rates.

Agenda

8:30 a.m. to 9:00 a.m. – PA PQC Successes and Future Directions – Aasta Mehta, MD, MPP and James A. Cook, MD, FAAP, PA PQC Advisory Group Co-Chairs

• Review the PA PQC’s collective impact on improving care for maternal OUD, NAS, severe hypertension, perinatal depression, and immediate postpartum LARC 2022 initiatives
• Recognize the hospitals that joined the PA PQC’s 2022 initiatives
• Review the next steps for the April 2022 through March 2023 Implementation Period

9:00 a.m. to 10:00 a.m. – Keynote: Trauma-informed Approach to Perinatal Care – Leena P. Mittal, M.D., Chief of the Division of Women's Mental Health at Brigham and Women's Hospital and Associate Medical Director for the Massachusetts Child Psychiatry Access Program for Moms (MCPAP for Moms)

• Dr. Mittal will discuss how healthcare can be re-traumatizing, trauma-informed care principles, how to implement the principles, and what trauma-informed care looks like in practice and in an organization.

10:00 a.m. to 10:15 a.m. – Break

10:15 a.m. to 11:55 a.m. – Overview of Breastmilk Feeding Guidelines for Substance Use and How to Empower Patients to Make Informed Decisions about Breastmilk Feeding with Community-Based Lactation Support Services – Debra Bogen, MD, Director of the Allegheny County Health Department

11:15 a.m. to 12:25 p.m. – PA PQC 2022 Initiative Breakouts

Each PA PQC participant will join one of the following virtual breakouts that pertains to their PA PQC quality improvement initiative.

Maternal Substance Use Breakout: – Connecting patients to community supports for Substance use

Facilitator: Pauline Taylor, CQIA , Program Specialist, Jewish Healthcare Foundation

In breakouts, highlight PA PQC healthcare teams with established relationships with community organizations and OUD Centers of Excellence (COE).

• What led them to that decision to establish these relationships?
• What made them realize they needed to do this?
• What did it take to establish these relationships?
• How did they recruit, train, an embed navigators and peer specialists on the team?
• How does the healthcare organization share data and communicate with the MAT program?
• What recommendations do they have for other PA PQC healthcare teams that want to establish these relationships?

Substance Exposed Newborn Breakout – Connecting families to community and outpatient services

Facilitator: Carol L. Frazer, MEd, LPC, Practice Transformation Specialist, Pittsburgh Regional Health Initiative

In breakouts, highlight PA PQC healthcare teams with established relationships with community organizations (Plans of Safe Care) and established programs to help the family stay with the newborn during the average five day say.

• What strategies and programs have enabled the parents to stay with the newborn during hospital stay (e.g., nurse/volunteer cuddler program and supports to enable the parent to continue MOUD including Methadone).
• What has worked well to educate families (during the prenatal period) about what to expect for substance exposed newborns and the types of services and supports that are available? How are these educational materials used across inpatient, outpatient, and community settings to reinforce key messages?

Immediate Postpartum LARC (IPLARC) Breakout: Measuring Expulsion Rates for Quality Improvement Purposes – Maya Oaks, Director of Reproductive Health Programs, ACOG; Nisha Verma, MD, Darney-Landy ACOG Fellow; Karena M. Moran, PhD, Research and Quality Project Manager, Northeastern PA Perinatal Quality Collaborative and Geisinger Health System 

1. An ACOG presenter/expert will provide an overview of best practices for calculating IPLARC expulsion rates (e.g., numerator and denominator specifications) and how these rates can be used for QI purposes (e.g., identifying a need for additional training, etc.) (25 min.)
2. Geisinger PA PQC IPLARC team shares their experience with expulsion rates (10 min.)
3. Peer-to-peer learning discussion with all the PA PQC IPLARC teams in the breakout (30 min.)

Moving on Maternal Depression (MOMD) Breakout: Establishing connections to health plan and community resources

Facilitator: Emily Magoc, RN-BSN, MPH, Quality Improvement Facilitator

Jewish Healthcare Foundations

Through a facilitated peer-to-peer learning discussion, the PA PQC MOMD teams will discuss strategies for how to connect families and patients to health plan and community resources:

• Education on common places/websites for how to find different types of behavioral health and community resources in PA
• Education on how all the MCOs use the ONAF results to risk stratify and follow-up with patients to connect them to resources, and implications for providers

PA AIM Severe Hypertension Breakout – Establishing connections to postpartum services and supports for hypertension

            Facilitator: Jennifer Condel, SCT(ASCP)MT, Manager, Lean Healthcare Strategy and Implementation, Pittsburgh Regional Health Initiative

• What has worked well to establish discharge navigation and coordination systems post childbirth to ensure that patients have appropriate follow-up care and understand when it is necessary to return to their health care provider?
• What has worked well to provide discharge instructions that include information about what danger or warning signs to look out for, whom to call, and where to go if they have a question or concern?
• What was worked well to design discharge materials that meet patients’ health literacy, language and cultural needs?
• How do you create support plans for patients, families, and staff for ICU admissions and serious complications of severe hypertension?
• What has worked and what hasn’t worked well to ensure follow-up within 7-14 days postpartum.

12:25 p.m. to 12:30 p.m. – Wrap-Up & Next Steps – Pauline Taylor, Program Specialist, Jewish Healthcare Foundation