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Turning the Tide

Turning the Tide is a Colorado hospital-based patient quality improvement initiative promoting the adoption of evidence-based practices to improve the identification, treatment, and ongoing support of pregnant and postpartum individuals with substance use disorders (SUD). The goal is to enhance the quality and consistency of care during the hospital birth admission and improve outcomes for both the birthing person and their infant.

Our hospital-based perinatal substance use quality improvement (QI) initiative aims to help every Colorado hospital screen for perinatal substance use during the hospital birth admission and prepares them to implement a comprehensive, multidisciplinary response before the patient is discharged. The initiative is centered on addressing stigma and bias, and promoting dyadic care, ensuring that both the birthing person and infant receive appropriate support.

Based on the model from The Alliance for Innovation on Maternal Health (AIM), a national quality improvement initiative, the initiative utilizes a structured approach known as “bundled care” to enhance care processes and achieve better outcomes for birthing individuals. These AIM bundles, endorsed by the American College of Obstetricians and Gynecologists, prioritize the use of data. By collecting and analyzing birth-related data, teams can make informed decisions and adjust their care strategies as needed.

The AIM safety bundle includes:


  • Universal Screening
  • SBIRT (Screening, Brief Intervention, and Referral to Treatment)
  • Naloxone Distribution
  • Staff Education
  • Respectful and Equitable Care

Hospitals participating in this initiative must maintain their status as Active Participants in CPCQC by fulfilling five levels of engagement. Once hospitals complete these initial requirements, they can opt for additional tailored options and elective components to further enhance care.

Enrollment

The hospital has signed a Data Use Agreement (DUA) with CPCQC and selected a QI initiative to implement.

Coaching

The hospital attends one virtual QI Coaching session with CPCQC per quarter (4 per year).

Survey Completion

Submit a survey about its practices related to the selected QI initiative at least twice per year.

Meeting Participation

-At least 1 hospital team member attends monthly virtual initiative meetings.

-Hospital representation at one annual forum.

Data Submission

-Submit monthly QI initiative data disaggregated by race, ethnicity, and payor.

-Submit a survey about hospital practices related to the selected QI initiative topic at least twice per year.

Adapted from the NNPQC and NICHQ publication “A Framework for Measuring Hospital Engagement Participation in PQC Quality Improvement Initiatives”, 2024

Additional tailored options and electives are available through this initiative:

MATERNAL OVERDOSE MATTERS PLUS (MOMS+)
Technical assistance to initiate MOUD during hospital birth admission

Dyadic Care for Perinatal Substance Use

Working across specialties to promote dyadic care in the hospital by partnering with  Colorado Hospital Substance Exposed Newborns (CHoSEN)