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EverThrive Illinois and Alliance Chicago co-lead the Chicago Collaborative for Maternal Health (CCMH) which is combatting the maternal mortality and morbidity crisis in Chicago by building awareness in communities and government, fostering collaboration among health and social service providers, and driving quality of care in ambulatory care settings. The work of CCMH is focused in six priority communities on Chicago’s south and west sides: East Garfield Park, West Garfield Park, Austin, Englewood, Greater Grand Crossing, and Chatham. 

To accomplish Aim 1, Alliance Chicago convenes Federally Qualified Health Centers to identify and implement quality improvement projects to improve health outcomes for pregnant and postpartum people. Following learning sessions and a needs assessment, this group has selected their first quality improvement program—increasing the percentage of high-risk pregnant patients connected to a primary care provider or medical home within six months of delivery. AllianceChicago led the creation of an implementation guide with resources for defining criteria to identify high-risk patients, help clinics prepare for changes to their processes and workflow, develop a patient registry, and additionally created measures and tools for tracking success.  

An important first step in implementing the quality improvement project was defining criteria to identify high-risk patients. While data from the state, City of Chicago, and nationally highlight certain conditions as putting patients at higher risk for adverse outcomes, AllianceChicago encouraged each health center to consider their respective patient populations to decide where they would focus this pilot project. Currently, all sites are focusing on patients with diabetes and gestational diabetes. Other high-risk conditions of focus are hypertension, pre-eclampsia and depression. Two health centers already had robust risk criteria models that look at additional conditions, and are adding on the process of connecting those patients back to primary care.

Four of six clinics in the implementation cohort are fully implementing this project across 16 locations with promising early results. 

At baseline, 25% of high-risk pregnant patients had completed a primary care visit in 2020, compared to over 80% who had completed a postpartum visit. This confirmed what our partners were seeing on the ground and voiced through the needs assessment as an area for improvement.

 

EverThrive Illinois launched train-the-trainer presentations for community organizations serving the CCMH priority communities to equip them with knowledge and resources about maternal health and mortality as they provide quality care to pregnant people and their families. The first cohort was comprised of 48 staff from two large community-based organizations; individuals who attended were home visitors, family support workers, doulas, parent coaches, and others who directly serve pregnant and postpartum people and their families. In these sessions, the cohort received an extensive overview of the disparities and causes of maternal mortality and morbidity, the data sources and the state’s review process, and participated in thoughtful conversation about crafting community-based solutions. 

Evaluations from this first cohort point to the value of this effort, with attendees reporting an increased understanding of the factors that contribute to maternal health, a better understanding of the importance of their role as a community provider, and more confidence in their ability to act on the information they gained to support pregnant and parenting people. Our second cohort will meet later this year.  

Additionally, EverThrive IL facilitated three focus groups with pregnant and recently postpartum people living in the CCMH priority communities. Participants provided rich insight into their personal experiences, including the impact of COVID-19 on their wellbeing, that will inform work across all CCMH aims. We hope to publish findings from those focus groups in the coming months, but preliminary themes highlight significant challenges meeting basic physical and mental health needs, systemic barriers to well-being like insurance issues and lack of parental leave, and little awareness of post-birth warning signs that indicate someone may be experiencing life-threatening complications. Taken together, these focus groups provide more depth for our understanding of how complex forces are driving poor health outcomes for pregnant and postpartum people and, ultimately, lead to the Black maternal mortality crisis.  

The Illinois General Assembly recently adjourned their session for the year, after passing several policies to directly affect the factors leading to high rates of and disparities in maternal mortality and morbidity. EverThrive IL summarized the policies affecting pregnant and postpartum people in a recent blog post.  

The activities described here are supported by a grant from Merck for Mothers, Merck’s $500M global initiative to help create a world where no woman has to die while giving life, as part of the Safer Childbirth Cities initiative. The content of this newsletter is solely the responsibility of the grantee organization and does not represent the views of Merck. Merck for Mothers is known as MSD for Mothers outside the United States and Canada.

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