The Institute for Healthcare Improvement (IHI), in partnership with Merck for Mothers, is working to deepen our understanding of the risks to Black mothers and birthing persons and their babies in the postpartum period, and to reduce inequities in morbidity and mortality. Between October and December 2022, IHI worked with experts in the field to collate evidence-based and promising clinical and social practices associated with care in the at-risk postpartum period in the form of a nested driver diagram, change package and preliminary measure set. From January through June 2023, IHI will convene a Learning Community of five hospitals in the US to understand how to apply evidence-based practice and quality improvement (QI) tools to understand the gaps and biggest opportunities, build a concise strategy that all health systems can use to tackle these high-risk areas, and convene national stakeholders to vet and align with this strategy.

Working with this small group of hospitals, IHI aims to understand how to best support changes to clinical and administrative processes that will lead to safer and more equitable postpartum care and support for Black mothers and birthing persons. We will work alongside the four hospitals to evaluate the available data, map out current processes, and develop a deeper analysis of “what matters to you” for birthing persons. This will help us determine high impact levers and create opportunities to improve access to and experience with postpartum care and support. As postpartum care and support include many health care specialties (e.g., Obstetrics (OB), labor & delivery, primary care, cardiology, and mental health) and occurs at the intersection of health care and community-based supports, we will work with health care systems to identify opportunities to engage across specialties and sectors. IHI will collate the learnings, modify the driver diagram, and change package product with lessons learned. Participating hospitals will receive coaching and support from IHI and from our clinical and improvement faculty. 

At the end of the six-month Learning Community, one of the participating hospitals will have the opportunity to work with IHI for an additional 6 months and engage with a specialized data tool called AdaptX. The AdaptX software provides an algorithm to collect, synthesize and report back routine data entered into the electronic medical record (EMR) on processes of care, stratified by race and ethnicity, by provider or unit. These near real-time reports offer the potential for hospital teams to enact high impact changes in the postpartum period to eliminate inequities in postpartum care. AdaptX will work the chosen organization to build a “live” data collection and reporting system for up to 10 postpartum process measures. IHI will partner with leaders within the different levels of the organization to provide sense making of the data, think about system opportunities, and help the front-line teams with PDSA (Plan-Do-Study-Act) ideas. IHI will work with the system QI team to support the clinical teams with the daily QI work. 

IHI will be working with these five US hospitals during the six-month Learning Community beginning in January 2023: