As we prepare to launch clOUDi, what may be one of the most important and challenging initiatives PQCNC has ever undertaken, it has been absolutely palpable how vital we all feel this work is for both moms and their babies. It is likely, based in work in other states, that only 1/3 of moms are being screened at delivery for substance use. This is unacceptable and tragic on multiple levels. In designing clOUDi the Expert Team was most passionate about the need to ensure that every mother, ideally prenatally, but certainly at the time of impending delivery, as recommended by the American College of Obstetrics and Gynecology, be screened for substance use using a validated verbal screening tool. In the multiple meetings of the clOUDi Expert Team, which includes providers of all types from hospitals of all types, it was very clear that such screening is not necessarily universal and it is commonly not with a validated screening tool.
In attempting to guide hospital teams in achieving 100% screening of all women at the time of delivery, the Expert Team agreed there would be great value in reviewing every delivery to determine whether proper screening had occurred. As we have begun enrollment of hospital teams and opened discussions with them about using this data to drive improvement, there has been concern that the task of reporting data for all deliveries over the coming year would be too onerous, and detract from the ability of teams to actually improve the screening processes...our aim.
PQCNC has always said the data cannot be the primary work of your hospital improvement teams…ever.
Recognizing the demanding realities we all are facing in clinical practice, and after much discussion, we believe it is necessary to revise the original data collection plan for the maternal side of clOUDi. At a minimum snapshots of this data (unbiased by sampling) are essential and we are re-designing our data systems.
So, we will ask all participant teams to send data on all deliveries for the months January 2021 (kickoff), August 2021 (halfway) and January 2022. In the intervening months we will ask that teams report only on mothers who screen positive.
We believe this will reduce the tracking burden considerably but still offer teams, and us as facilitators, the information we need to guide the maternal PDSA and quality improvement interventions of clOUDi.
For those teams who have already joined - thank you for your commitment and for sharing this journey with us.
For those teams who have not yet joined - it is our sincere hope that this will relieve the anxiety many shared over the intensity of the proposed data collection, allowing you to give the go ahead to your hospital clOUDi team to register and begin considering how you will achieve 100% screening of women delivering in your hospital with a validated verbal screening tool.
The time is now to get your hospital and hospital team registered - click the button below and be ready for the kickoff in January!
We will make North Carolina the best place to give birth and be born!
Thank you…as always.
Marty
