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Date and Duration: December 2019 – October 2020 (10 months)

Preterm Birth Prevention Initiative

Purpose

Between 2012-2016, Prematurity was the second leading cause of infant mortality in Minnesota, contributing to 24.7% of all infant deaths. In 2019, 1 in 11 MN babies were born prematurely, with significant disparities for Black (9.7%) and Native American (15.2%) women/birthing people. Furthermore, the average cost of premature birth is staggering. For a baby born to term, the average cost is $4389; for a premature baby, it is 11x more expensive at $54,194.

Minnesota Preterm Birth Reduction Initiative
References

1. March of Dimes. State Summary For Minnesota. https://www.marchofdimes.org/peristats/state-summaries/minnesota?lev=1&obj=3&reg=99&slev=4&sreg=27&stop=55&top=3

2. Minnesota Department of Health. Infant Mortality.; 2021. https://www.health.state.mn.us/docs/communities/titlev/infantmortality2021.pdf

3. Nationla Health Start Association. How Much Does Preterm Birth Cost the Nation? https://www.nationalhealthystart.org/wp-content/uploads/2021/06/Cost-of-IM-Preterm-Birth-to-Nation-2021.pdf

Goals & Objectives

1. Assess Individual Health barriers and facilitate solutions to improve the process of 17p utilization

2. Assess and increase provider knowledge of progesterone and appropriate uses

3. Utilize the Electronic Medical Record (EMR) to identify candidates for 17p and track administration

4. Implement a standardized Order Set for 17p through EMR

5. Streamline procurement of 17p by centralizing prior authorization

6. Implement a standardized process for evaluation of cervical length in 17p candidates

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.
Example: Reduction in severe maternal morbidity rates or improvement in patient satisfaction scores.
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.
Example: Percentage of patients treated for severe hypertension within 60 minutes or compliance with a standardized care pathway.
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.
Example: Monitoring readmission rates or the burden of increased documentation on staff.
Purpose: To ensure that changes made to improve one outcome do not create new problems elsewhere.

Family Of Measures

Family of Measures

Outcomes Measures

1. Percentage of eligible women/birthing persons offered 17p based on a preterm treatment algorithm

2. Percentage of women/birthing person with a preterm birth: “What matters most to you about your pregnancy and birth

Process Measures

1. Percentage of women/birthing persons assessed for preterm singleton birth at first prenatal visit up to the 24th week of pregnancy

2. Percentage of women/birthing persons offered 17p who are offered a formal teach-back

3. The time between prescribing and administration of the first 17p dose

4. Percentage of women/birthing persons who adhere to 17p

5. Percentage of women/birthing persons receiving 17p with a follow-up “touch” based on interval co-produced by the care team and the woman/birthing person

Balancing Measures

1. Gestational birth week of babies born to mothers with a previous premature birth who adhere to 17p

Toolkit

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

17P Poster- Reducing Preterm Birth
17P Driver Diagram
Preterm Birth BPA
17P Flowchart
Preterm Birth Overview
Preterm Birth Treatment Algorithm
17P FAQs

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.