Vermont Child Health Improvement Program

Alliance for Innovation in Maternal Health (AIM) is a national maternal safety and quality improvement initiative. As part of the PQC-VT, Vermont joined AIM in 2020 with the goal of implementing safety bundles in all our birthing hospitals in an effort to improve care, prevent complications during pregnancy, and in turn reduce the occurrence of severe maternal morbidity in pregnant Vermonters.

Vermont joined the Alliance for Innovation in Maternal Health (AIM), a national maternal safety and quality improvement initiative, in 2020. AIM’s goal is to implement maternal safety bundles in hospitals to improve care, prevent complications during labor and delivery, and reduce severe maternal morbidity.

Since joining, Vermont has implemented two safety bundles with 100% of the birthing hospitals in the state. Our first bundle (launched 20202) was focused on reducing Obstetric Hemorrhage and the second bundle (launched fall 2022) is focused on reducing Severe Hypertension in Pregnancy.

Vermont chose to start with these two bundles due to state severe maternal morbidity data available at the time we joined. Postpartum Hemorrhage and Hypertension were the top two leading causes of morbidity in the state.

Goals & Accomplishments

The goal of implementing AIM safety bundles is to improve the clinical structures and processes of care and improve patient outcomes for pregnant Vermonters throughout the state. This is done with standard, actionable steps that have been proven to reliably improve patient care. 

Accomplishments:

• 100% of VT birthing hospitals are enrolled
  
• We rolled out quick drill binders on both Hemorrhage and Hypertension to assist hospitals with implementing regular drills.

Obstetric Hemorrhage

Goal: reduce the number of preventable obstetric hemorrhages
Rollout: 2020
Highlights from 2023 report:

• Prior to bundle implementation, 55% of hospitals had protocols in place to support patients, family and staff through major OB complications. By the end of Q2, this number rose to 64%.
  
• Prior to bundle implementation, 73% of hospitals had a process to perform multidisciplinary systems-level reviews on all cases of severe maternal morbidity. By the end of Q2, this number rose to 82%.
  

Severe Hypertension in Pregnancy

Goal: reduce the number of hypertensive emergencies in pregnancy
Rollout: Fall 2022