PNQIN MA AIM Initiative 

PNQIN is excited to team up with the Alliance for Innovation on Maternal Health (AIM) Program to support the implementation of maternal safety bundles in birthing facilities, clinics, and hospitals across MA.

This page introduces different components of the MA AIM Initiative.
For quality Improvement Resources, or for general AIM Implementation Guides, please visit the pages via the links below.
AIM OUD Hospital Teams: To access Wave 1 or 2 Team pages, or AIM OUD Onboarding Support, please visit the links below.

PNQIN has identified the following bundles as priorities for MA AIM:

  • Obstetric Care for Women with Opioid Use Disorder
  • Obstetric Hemorrhage

  • Severe Hypertension in Pregnancy

  • Safe Reduction of Primary Cesarean

  • Reduction of Peripartum Racial/Ethnic Disparities

 

What is AIM?

Responding to a disturbingly rising maternal mortality rate in the U.S, a national partnership of provider, public health and advocacy organizations developed the Alliance for Innovation on Maternal Health (AIM). AIM works through state teams and health systems to align national, state, and hospital-level quality improvement efforts to improve overall maternal health outcomes.

What are Maternal Safety Bundles?  

Developed by multidisciplinary workgroups of experts in the field, bundles are standardized evidence-informed toolkits to reduce variation in response to common issues arising in maternal care. Currently, AIM has developed 11 different bundles that focus on specific maternal health and safety topics including obstetric hemorrhage, preeclampsia, and opioid use among pregnant patients. All of the bundles provide a number of resources such as implementation guides, educational documents, and informative guidelines to support better policies and practices that aim to ultimately address these issues commonly associated with preventable maternal mortality and morbidity.

For more information on the National AIM Program, check out the AIM website by clicking here.

 Why are we partnering with AIM

 
The United States has the highest maternal mortality rate among all high resource countries—and it is the only country outside of Afghanistan and Sudan where the rate is rising!
Across Massachusetts:

1.

Black women are between 3 – 4X more likely to die following childbirth than White women

2.

Approximately 1 in 5 pregnancy-associated deaths (20.6%; n=41) was related to substance use in Massachusetts from 2005 to 2014

3.

The rate of SMM increased 179% between 1998 to 2013 (from 57 per 10,000 delivery hospitalizations to 159 per 10,000 delivery hospitalizations)

4.

Among pregnant women enrolled in the MA Bureau of Substance Addiction Services (BSAS) treatment system, 20% of pregnant women reported the use of opioids.

AIM Implementation has Several Benefits

 

Proven Interventions

1. Uses proven medical interventions and recommendations

Care Standardization

2. Informs care standardization to reduce variation of treatment across hospitals and systems, but can be tailored to meet local needs

Resources and Tools

3. Provides resources and  implementation tools for collaborative improvement across the state and locally

Timely Data

 

4. Generates data that can track results and progress and can be used for benchmark against peers (both statewide and nationally)

Improves Outcomes

5. Improves Outcomes for Severe Maternal Morbidity and Mortality​

Early outcomes revealed reduced SMM associated with hemorrhage and maternal mortality in California

Learn More about the MA AIM Initiative by Visiting the Project Sections Below!

AIM WAVE 1

Click to View Wave 1 Hospitals


Wave 1 began Summer 2019 and enrolled 22 of the 44 birthing institutions. ​​




AIM OUD Wave 1 Team Resources


Participating hospitals, please visit the AIM OUD Wave 1 Resources page to access resources for the AIM Opioid Engagement Wave 1. This site is password protected. Please e-mail PNQIN Admin (pnqinadmin@pnqinma.org) for the password if prompted.




Wave 1 OUD in Pregnancy Webinars


Participating Wave 1 Hospitals, please click here for an archive of the OUD in Pregnancy Monthly Webinar slides and audio recordings! This site is password protected. Please e-mail PNQIN Admin (pnqinadmin@pnqinma.org) for the password if prompted.





AIM WAVE 2

Join MA AIM! - Now Enrolling Wave 2 Hospitals for the AIM OUD Bundle


Wave 2 will aim to enroll the remaining 22 hospitals!




AIM OUD Wave 2 Launch and Team Resources


Participating Wave 2 hospitals, please click HERE to view current resources. This site is password protected. Please e-mail PNQIN Admin (pnqinadmin@pnqinma.org) for the password if prompted.




Wave 2 OUD in Pregnancy Webinars


Participating Wave 2 Hospitals, please visit this page soon for an archive of the OUD in Pregnancy Monthly Webinar slides and audio recordings! This site is password protected. Please e-mail PNQIN Admin (pnqinadmin@pnqinma.org) for the password if prompted.





MAT and TIC Trainings

Buprenorphine Waiver Training in Collaboration with BMC OBAT TTA


PNQIN is partnering with the BMC OBAT team to offer three regional Medication-Assisted Trainings in 2020. For more information and to Register, Click HERE




Stigma, Bias, and Trauma-Informed Care Training in collaboration with Brigham & Women's C.A.R.E Team


PNQIN is partnering with the Brigham & Women's C.A.R.E Team to offer stigma, bias, and trauma-informed care trainings to reduce stigma and bias in care for patients experiencing substance use disorders. To learn more and find out if your site is eligible to register for a training, please e-mail PNQINAdmin@pnqinma.org.





AIM Implementation

National and Local AIM Resources


For more AIM resources, click HERE




AIM OUD Toolkit


MPQC Maternal Opioid Use During Pregnancy Toolkit Click HERE to access the MPQC Maternal Opioid Use During Pregnancy Toolkit. This toolkit was developed by all the maternal health providers that encompass the Massachusetts Perinatal Quality Collaborative, the Massachusetts Department of Public Health, Bureau of Substance Abuse Services, Boston Medical Center’s STATE OBAT-B, and Institute for Health and Recovery. Additional thanks goes to Massachusetts Child Psychiatry Access Project (MCPAP for Moms) and Massachusetts Perinatal-Neonatal Quality Improvement Network with whom the initial document was conceptualized.




Boston Medical Project Management Tool


Download the Tool Here




AIM Bundle Components Overview


Click HERE for a copy of the AIM Bundle Components, as published by ACOG.




MA OBAT Clinical Guidelines


Visit MA OBAT for more Information Boston Medical Center Injectable Buprenorphine Protocols
These guidelines should be used to inform the administration of injectable buprenorphine at Boston Medical Center.
(Download file) Boston Medical Center OBAT Clinical Guidelines
This version of the OBAT Clinical Guidelines should be used by health centers in Massachusetts.
(Download file) Boston Medical Center Project RESPECT Guidelines for Treating Opioid Use Disorder in Pregnant and Parenting Patients
These guidelines should be used to inform the treatment of pregnant and parenting patients with opioid use disorder at Boston Medical Center.
(Download file) National OBAT Clinical Guidelines
This version of the clinical guidelines has more general, non-Massachusetts-specific information on the Nurse Care Manager model of Office Based Addiction Treatment.
(Download file)




NY ACOG District II Opioid Use Disorder in Pregnancy Bundle- Provider Education Slide Deck


New York ACOG District II Opioid Use Disorder (OUD) in Pregnancy Bundle – Part 2 Provider Education Slide Deck. This slide deck focuses on the response and reporting sections of the AIM bundle and includes management of acute withdrawal, initiation on MAT, intrapartum and postpartum pain management, postpartum care, breastfeeding, plan of safe care, home visiting, and case studies. It can be found HERE





 

A cooperative voluntary program involving Massachusetts maternity facilities and key perinatal stakeholders, designed to promote the sharing of best practices of care.