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Initiative Status:

Date and Duration: September 2025 – April 2026

Obstetrical Hemorrhage Community of Learning (COL)

Purpose

To increase the proportion of Minnesota birthing facilities with the training, standardized protocols, and resources needed to effectively identify, prevent, and manage obstetric hemorrhage- particularly in communities most affected by maternal health disparities. Through collaborative learning, the program will improve continuity in clinical practices and protocols and promote respectful care delivery.

Obstetrical Hemorrhage Community of Learning Charter

Session Dates & Details

Virtual Group Orientation

  • September 24, 2025 at 12 PM

In-Person Kickoff Meeting

  • October 27, 2025 at 4 PM

Virtual Action Period Calls (APC)

  • December 3, 2025 at 12 PM
  • January 14, 2026 at 12 PM
  • February 11, 2026 at 12 PM
  • March 11, 2026 at 12 PM
  • April 22, 2026 at 12 PM

Goals & Objectives

Program Goals

1. Improve the clinical readiness and response of Minnesota birthing facilities to obstetric hemorrhage. 

2. Standardize the implementation of the AIM Obstetric Hemorrhage Bundle across participating sites. 

3. Promote respectful care by addressing resource disparities and adapting strategies to meet local needs.

Program Objectives

1. Participating sites will implement a standardized protocol for measuring quantitative blood loss.

2. Participating sites will demonstrate progress toward fully implementing and maintaining obstetric hemorrhage policies and procedures, including:

  • An obstetric rapid response team appropriate to the facility’s Maternal Level of Care
  • A standardized, stage-based hemorrhage emergency management plan with checklists and an escalation policy
  • Emergency release and massive transfusion protocols
  • A protocol for patients who decline blood products

3. Participating sites will establish a process for conducting clinical and patient debriefings following hemorrhage events.

4. Participating sites will establish a process for conducting and documenting hemorrhage risk assessments for all birth admissions, including risk level assignment prior to delivery.

5. Participating sites will confirm the availability of a stocked hemorrhage cart in all relevant units.

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.

Structural Measures

Definition: Metrics that assess the foundational capacities, infrastructure, resources, and organizational supports that enable high-quality care. These measures evaluate whether the systems, tools, and structures necessary for effective processes are in place.
Purpose: To determine whether teams have the essential infrastructure needed to reliably carry out processes and achieve desired outcomes. Structural measures help identify gaps in readiness, capacity, or resources that may hinder implementation or improvement.

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

Outcome Measures

1. Severe Maternal Morbidity (excluding transfusion codes alone)

2. Severe Maternal Morbidity Among People Who Experienced an Obstetrical Hemorrhage (excluding transfusion codes alone)

3. Obstetrical Hemorrhage

Process Measures

1. Provider Education on Respectful and Equitable Care

2. Nursing Education on Respectful and Equitable Care

3. Unit Drills – Number of Drills

4. Unit Drills – Topics

5. Provider Education on Obstetric Hemorrhage

6. Nursing Education on Obstetric Hemorrhage

7. Hemorrhage Risk Assessment

8. Patient Support After Obstetric Hemorrhage

9. Quantified Blood Loss

Structure Measures:

1. Patient Event Debriefs

2. Clinical Team Debriefs

3. Multidisciplinary Case Reviews

4. Patient Education Materials on Urgent Postpartum Warning Signs

5. Hemorrhage Cart

6. Unit Policies and Procedures

7. Quantitative Blood Loss

Toolkit

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

AIM Obstetric Hemorrhage Bundle
ACOG Obstetric Hemorrhage Bundle
CMQCC Hemorrhage Webpage

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 our partners.