Overview
West Virginia has been an AIM state since 2018, with the implementation of the Obstetrical Hemorrhage Patient Safety Bundle. With participation from all delivering hospitals in the state, the Obstetric Hemorrhage Patient Safety Bundle elements were instituted in the majority of the facilities. Development of hemorrhage boxes, emergency policies and procedures and education for staff and providers were implemented.
In the fourth quarter of 2022, 98.5% of birthing facilities reported implementation of a hemorrhage risk assessment to identify women at increased risk for obstetric hemorrhage. 89.7% report using quantitative blood loss assessment, a recommended procedure for early identification of increasing blood loss leading to earlier detection of hemorrhage.
Our Approach
We believe evidence-based quality improvement initiatives are the key to improving maternal health outcomes.
Currently, West Virginia is coordinating efforts to implement the Severe Hypertension in Pregnancy Patient Safety Bundle in all delivering facilities. Obstetric care providers and hospital staff have participated in emergency simulation drills, created policies and emergency protocols to identify, diagnose and treat severe hypertension in pregnancy quickly and effectively. Eighty percent of hospitals report using staff debriefs and multidisciplinary reviews to improve patient outcomes and experiences.
We work to improve maternal health outcomes by aligning national, state and hospital-level quality efforts via multiple collaborative projects. Explore our projects:
Despite West Virginia having an overall severe maternal morbidity (SMM) rate of 3.2% in 2017 and having implemented a four-year educational program from 2012-2016 on obstetric hemorrhage in all delivery hospitals, the rate of women experiencing obstetric hemorrhage who developed SMM continued to rise. In response, the West Virginia Perinatal Partnership launched a two-year collaborative to implement the AIM Obstetric Hemorrhage Patient Safety Bundle in 2018.
In 2017 severe maternal morbidity (SMM) from hypertension was 7.6%, despite an overall SMM for all obstetric complications being less than 2%. In 2020 the West Virginia Perinatal Partnership initiated implementation of the AIM Severe Hypertension in Pregnancy patient safety bundle in all delivering hospitals in the state.
The West Virginia Perinatal Partnership is actively engaged in working to promote risk appropriate care for mothers and babies across the state. Designation of Levels of Care, maternal and neonatal, have been explored through the implementation of the Centers for Disease Control (CDC) LOCATe program, and work groups evaluating perinatal outcomes at all levels. Learn more about LOCATe.
In addition to this analysis of maternal outcomes, the WVPP is engaged in current work to explore preterm births in the state. Starting with the delivery of very low birth weight infants outside of tertiary care centers, and building to a larger review of preterm deliveries, the aim is to help babies be “Born in the Right Place”.
Our Team
Melanie Riley, MSN, RN, C-EFM
Nurse Coordinator
Full Bio