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Project Name: Alliance for Innovation on Maternal Health State Capacity Program (A30)
Applicant Title: University of North Dakota
Abstract Text: HRSA Project Abstract: 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202 Andrew Williams, PhD, MPH xxx-xxx-xxxx xxxxxxxxxxxxxxxxx@xxx.xxx www.NSDPQC.org Funds Requested: $800,000 (Year 1: $200,000; Year 2: $200,000; Year 3: $200,000; Year 4: $200,000) Adequate prenatal care is critical for promoting the health and well being of both mother and baby, ensuring a successful pregnancy and birth outcomes. Rural-urban disparities in access to prenatal care are a significant public health issue in North Dakota. Rural women are more likely to receive late or no prenatal care which can lead to adverse outcomes. Rural areas have fewer healthcare providers and facilities, making it more difficult for pregnant women to access prenatal care. The majority (79%) of rural hospitals in North Dakota do not offer labor and delivery services. As many pregnant women from rural communities change care providers during prenatal care, it is essential that all health care facilities (birthing hospitals, non-birthing hospitals, private OB/GYN clinics, federally qualified health centers, community clinics, etc.) and health care providers (physicians, advance practice nurses, physician assistants, midwives, doulas, home visiting, etc.) that offer any type of prenatal care are implementing best practices in order to improve perinatal outcomes in ND. The North Dakota (ND) leadership team of the North & South Dakota Perinatal Quality Collaborative (NSDPQC) is working in partnership the University of North Dakota (UND) to implement Patient Safety Bundles created by the Alliance for Innovation on Maternal Health (AIM) in regional birthing facilities and critical access hospitals. Rural clinics and critical access hospitals are usually the first touch point for prenatal care for the large rural population of North Dakota. This project will work to engage both non-birthing hospitals and clinics of North Dakota in quality improvement initiatives lead by the NSDPQC. The NSDPQC is currently supporting quality improvement work and AIM data collection in seven birthing hospitals in North Dakota covering 81% of the births. However, there has been no formal engagement among North Dakota non-birthing facilities. AIM bundles are designed to improve perinatal outcomes in large birthing facilities, not non-birthing facilities in rural areas and other small communities. Using a Community Based Participatory Research (CBPR) approach, NSDPQC will work with non-birthing facilities and their patients to modify AIM Patient Safety Bundles that fit non-birthing facility needs, and ongoing professional trainings on the latest best practices and patient education materials. By engaging non-birthing and patients seeking prenatal care at non-birthing facilities, NSDPQC will identify challenges that non-birthing facilities face in implementing AIM bundles as currently designed and innovate modifications to AIM bundles to address needs and capacity of non-birthing facilities. NSDPQC will lead modification of AIM bundles, dissemination of best practices, and patient education materials. The project will improve maternal and infant outcomes in North Dakota, especially in the rural and low-income populations through advancing evidence-informed clinical practices and processes using quality improvement principles to address gaps in care. The funding will expand the capacity of the NSDPQC by hiring personnel to support the quality improvement work in non-birthing facilities. Research and data collected throughout this project will help inform future quality improvement initiatives and direction of the NSDPQC.