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Date and Duration: September 2021 – October 2024 (3 Years, 1 Month)

Mother/Infant Opioid Substance Treatment and Recovery Effort (MOSTaRE) Initiative

Purpose

Perinatal substance use and opioid use disorders are the leading causes of maternal morbidity and mortality in Minnesota, posing significant challenges to the health and well-being of pregnant individuals and their infants. By integrating evidence-based AIM (Alliance for Innovation on Maternal Health) bundles, fostering collaboration among hospital teams, and providing learning sessions with content experts, the MOSTaRE initiative achieved a measurable impact.

Mother/Infant Opioid Substance Use Treatment and Recovery Effort (MOSTaRE) Initiative Charter
References

1. Minnesota Department of Health. Minnesota Maternal Mortality Update Reporting for 2017-2019.; 2024. https://www.health.state.mn.us/people/womeninfants/maternalmortality/maternalmortreport.pdf

Goals & Objectives

1. Improve the identification and treatment of substance use disorders (SUDs) in pregnant individuals.

2. Enhance the use of nonpharmacologic methods for treating opioid-exposed infants.

3. Reduce the hospital length of stay for infants exposed to opioids.

4. Integrate evidence-based AIM (Alliance for Innovation on Maternal Health) bundles.

5. Foster collaboration among hospital teams to streamline care processes.

It successfully increased the identification and treatment of SUDs during the perinatal period by over 50%, while also promoting nonpharmacologic care for infants and reducing their average hospital length of stay.

How Success Is Tracked

A family of measures is a set of related metrics used in Quality Improvement (QI) initiatives to assess the overall impact, outcomes, and processes of a project. These measures provide a comprehensive picture of the initiative’s effectiveness and guide decision-making. A family of measures typically includes three types of metrics:

Outcome Measures

Definition: Metrics that reflect the ultimate goals or results of the initiative, focusing on the impact on patients, populations, or systems.
Purpose: To evaluate whether the initiative achieved its desired results.

Process Measures

Definition: Metrics that assess whether specific actions or interventions were implemented as intended. These focus on the steps or processes involved in achieving the outcome.
Purpose: To monitor the implementation and effectiveness of the processes driving the outcomes.

Balancing Measures

Definition: Metrics that ensure improvements in one area do not negatively affect other areas. They check for unintended consequences or trade-offs.
Purpose: To ensure that changes made to improve one outcome do not create new problems elsewhere.

Family Of Measures

Family of Measures

Stratify by race/ethnicity where available

State Surveillance:

1. SUD among pregnant and postpartum people (SS1)

2. Severe Maternal Morbidity (SMM) including transfusion codes) among people with SUD (SS2)

3. Severe Maternal Morbidity (SMM) (excluding transfusion codes) among people with SUD (SS3)

4. Proportion of pregnancy associated deaths due to overdose (SS4)

Outcome Measures:

1. Percent of newborns exposed to substance in utero who were discharged to either birth parent (O1)

2. Percent of pregnancy and postpartum people who received or were referred to recovery treatment services (O3)

3.Length of stay of all opioid exposed newborns

Process Measures

1. Percent of pregnant and postpartum people screened for SUDs (P1)

2. Number of Provider and Nursing education – Respectful and Equitable Care

Structure Measures:

1. Resource Mapping/Identification of Community Resources (S1)

2. Number of Patient Event Debriefs (S2)

3. General Pain Management Guidelines (S3)

4. OUD Pain Management Guidelines (S4)

5. Validated Screening Tools and Resources Shared with Prenatal Care Sites (S5)

Toolkit

Our toolkits provide targeted resources specific to each QI program, offering essential materials to support healthcare teams in achieving improvement goals.

Driver Diagram
AIM Bundle- Care for Pregnant and Postpartum People With Substance Use Disorder
Plans of Safe Care
MHA Perinatal Substance Use Road Map
Validated SUD Screening Tools

Reports

MOSTaRE (Mother/Infant Opioid Substance Use Treatment and Recovery Effort) Initiative

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MNPQC’s Quality Improvement Programs were developed with support and guidance from hospital teams and professional faculty throughout the state of Minnesota. The contents do not necessarily represent the official views of, nor an endorsement, by MNPQC or our partners.