MCHbest. NPM 3: Risk-Appropriate Perinatal Care
Strategy. Multicomponent: Access to Providers through Hotline + Continuing Education of Hospital Providers + State Policies/Guidelines
Approach. Support development of a 3-pronged approach by developing a 24-hour hotline, support establishment of intra-hospital transport system, and develop a Continuing Medical Education (CME) module.
Overview. Telemedicine decreased deliveries of VLBW neonates in hospitals without NICUs and was associated with decreased statewide infant mortality.1
Evidence. Emerging. The evidence of effectiveness for interventions with a patient component is less clear. Access the peer-reviewed evidence for provider hotlines through the MCH Digital Library. Access evidence for continuing education. Access evidence for state policies/guidelines. (Read more about understanding evidence ratings).
Target Audience. Patients + providers + state/national.
Outcome. VLBW births at risk-appropriate settings. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.
Examples from the Field. There are currently several ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of ESMs related to patient engagement through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM. Access hospital-based ESMs here. Access population-level ESMs here.
Sample ESMs. Using the approach “Support development of a 3-pronged approach in caring for at-risk patients by developing a 24-hour hotline for obstetric and neonatal providers to utilize in centers of level II or lower, support establishment of intra-hospital transport system for high-risk mothers and newborns and develop CME module on transportation guidelines of high-risk mothers and newborns for healthcare providers,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4):
1Kim EW, Teague-Ross TJ, Greenfield WW, Keith Williams D, Kuo D, Hall RW. Telemedicine collaboration improves perinatal regionalization and lowers statewide infant mortality. J Perinatol. 2013;33(9):725-730.