Hypertension is a common medical disorder in pregnancy in the United States. Preliminary data from PeriData.Net® show that in Wisconsin, hypertensive disorders affect approximately 22% of pregnancies.

These disorders are also leading contributors to neonatal morbidity and mortality, with approximately 15-20% of NICU admissions being associated with maternal hypertension. The aim of this initiative is to increase the number of providers (defined as hospitals or health systems) who use evidence-based protocols for screening and managing women with hypertension in the antepartum, intrapartum, and postpartum period. WisPQC accomplished this aim through the 2015 Regional Forum Series.

History

In 2015, the Wisconsin Association for Perinatal Care (WAPC) received funding from the Wisconsin Department of Health Services to develop the infrastructure for a statewide perinatal quality collaborative. WisPQC’s member organizations selected maternal hypertension as the inaugural initiative. The WAPC Regional Forum Series in 2015 served as the educational intervention for Cohort I, and participants submitted data beginning January 2016. Later in 2016, using the lessons learned from Cohort I, WisPQC launched Cohort II with a revised and more complete set of measures.

Cohort I (2016) focused on four quality measures:

Maternal length of stay
Provider education
Consumer education
NICU admission/transfer

Cohort II (2016) focused on seven quality measures:

Maternal length of stay
Consumer education
NICU admission/transfer
Low-dose aspirin with maternal risk factors
Appropriate medical management in less than 60 minutes
Debriefs for severe range hypertension
Severe maternal morbidity

In 2019, the Wisconsin Association for Perinatal Care, submitted an application to the Alliance for Innovation on Maternal Health (AIM), on behalf of WisPQC. AIM is a national data-driven maternal safety and quality improvement initiative based on proven implementation approaches to improving maternal safety and outcomes in the U.S. AIM’s goal is to eliminate preventable maternal mortality and severe morbidity across the United States.

AIM works through state teams and health systems to align national, state, and hospital level quality improvement efforts to improve overall maternal health outcomes.

The application was approved and Wisconsin became an “AIM state.” WisPQC selected the Severe Maternal Hypertension bundle and held its launch for AIM on March 17, 2020.