Colorado Perinatal Care Quality Collaborative

“The board will authorize preparation of form 990. Form 990 will be prepared by the auditors in consultation with the treasurer, president/chair, and executive director, and will be signed by an officer of the board. A copy of form 990 will be filed in cpcqc financial files, and a copy of the form 990 and form 1023 shall be made available for public inspection and/or copying.”

“Colorado perinatal care quality collaborative makes its governing documents, conflict of interest policy, and financial statements available to the public on an "as requested" basis.”

“Cpcqc - cpcqc leads four active qi initiatives that address high-priority needs across the state's perinatal population. A primary focus of our projects is to address the opioid epidemic's impact on birthing persons and their infants. Because we know that mental health disorders are not only a leading cause of maternal death, but also a major comorbidity of substance use disorders, our programs also address perinatal mood and anxiety disorders in addition to support for social needs. Additionally, because we know that gaps in care across the perinatal continuum lead to negative health outcomes, including maternal mortality due to "deaths of despair," cpcqc is spearheading work to improve the comprehensiveness and continuity of care across ob and neonatal care, behavioral health treatment, and social supports throughout the perinatal period.”

“Colorado hospitals substance exposed newborns (chosen qic) - variability across colorado hospitals exists in maternal and infant drug screening, infant assessment for withdrawal, location of care for substance exposed newborns, degree of engagement of birthing parents, pharmacologic treatment modalities, initiation and weaning protocols, criteria for discharge, and many other elements of care. Since 2017, chosen qic has led efforts to increase consistency in clinical care practices and optimize family engagement during birth hospitalization. When the program started in 2017, nearly 70% of substance exposed newborns (sen) at hospitals in the program were treated with medication. By 2019, the rate declined to 23% and most recently, 0% of sens were treated with medication in participating hospitals. The average hospital stay for sens also decreased from over 2 weeks to 6 days. Twenty-six hospitals total are engaged in chosen qic, with 19 in colorado. While the birth outcomes measures far exceeded our initial aims, chosen qic recognized that the periods before and after birth hospitalization require greater targeted interventions. Rates of prenatal education of families about the care of sens and rates of completion of a transition plan to the outpatient pediatric providers were far from optimal at less than 20%. Additional five-year funding would allow chosen qic to focus on these periods of transition as we continue to sustain birth hospitalization outcomes. Of the 19 participating hospitals, 14 are actively engaged in qi work (23.7% of co hospitals). These 14 hospitals deliver 37% of colorado births each year. The chosen collaborative in colorado accounts for 85.7% of regional accountable entity (rae) regions and 65% of health statistic regions (hsrs).”

“Colorado aim substance use disorder learning collaborative (co aim: sud lc) aim sud lc is an initiative aligned with healthy people 2030 goals, colorado's state medicaid hospital quality incentive project (hqip), and cdphe's maternal mortality review committee recommendations. There is a significant need to enhance care for perinatal patients in colorado with substance use and mood and anxiety disorders. Such care is administered unevenly across populations and, subsequently, some patients are left untreated which can lead to preventable deaths from the two leading causes of maternal death in colorado - suicide and accidental overdose.3 co aim: sud lc focuses on increasing and improving identification, diagnosis, and treatment for substance use disorder and perinatal mood and anxiety disorders in pregnant and postpartum individuals. This qi initiative establishes guidelines and protocols for screening, brief intervention, and referral to treatment (sbirt) for substance use disorder (sud) and perinatal mood and anxiety disorders (pmads) in the perinatal healthcare setting. It is based on the aim obstetric care for pregnant and postpartum people with substance use disorder patient safety bundle. Participating co aim: sud lc hospitals have seen a 144% increase in overall comprehensive universal screening for anxiety, depression, and substance use. The program began in february 2021, and has now grown to have 50.4% of colorado live births delivered in co aim: sud lc-participating hospitals. Additional five-year funding would allow co aim: sud lc to increase not only screening, but referral for treatment and focus on clinical community linkages and engaging more individuals with lived experience as we continue to sustain birth hospitalization outcomes.”

“Data-driven engagement of families to improve the nicu experience in colorado (define colorado) - define colorado seeks to optimize the engagement of parents affected by prolonged nicu hospitalization for their preterm infants, centering their role in the medical and developmental care of their newborns. In particular, define colorado seeks to identify and address the social determinants of health that impact parents' ability to be present and engaged in their infants' care in the nicu, thereby also reducing disparities in parental engagement by race/ethnicity, primary language, and geographic location. Define colorado improves parental engagement by using a quality improvement framework with implementation of a bundle of care practices. Critically important, define focalizes the experience of parents and the reduction of disparities in this effort. Unlike other qi initiatives that rely on electronic medical record (emr) or state vital statistics data, define collects data on the parent experience through longitudinal electronic surveys to parents of hospitalized preterm infants that are then linked to clinical data. Moreover, define recognizes that sociodemographic data from the emr is often inaccurate or missing, making it nearly impossible to measure and then reduce disparities. Thus, define collects this critically important information directly from parents who self-report their race/ethnicity, primary language, and residence. Because infants of color are over-represented in nicus, this project serves and supports minoritized families. By focusing on family engagement in the nicu and also relying on parent reports of engagement, define is serving and supporting families who bear the greatest burden of prematurity and its associated complications. Define launched last year and at present, 13.3% of colorado live births are delivered in define-participating hospitals. Supporting vaginal delivery for low-risk mothers (soar) - soar aims to improve maternal outcomes by reducing variation in care often associated with geographical location and reduce the risks and complications that result from unnecessary cesarean sections in low-risk populations. Soar is an initiative aligned with healthy people 2030 goals, joint commission requirements, and colorado's state medicaid hospital quality incentive project (hqip) to reduce unnecessary cesarean delivery for low-risk, first-time pregnant people (nulliparous, term, singleton, vertex births, or ntsv). The aim safe reduction of primary cesarean birth patient safety bundle and aim data center are used to support this project. Participating soar hospitals average a 24.4% ntsv cesarean birth rate compared to the national average of 30.6%.16 soar participating hospitals deliver 29% of colorado births.”

“Other contractor fees 170,155 7,904 26,845”