In October 2010, the Indiana Department of Health’s (IDOH) Division of Maternal and Child Health (MCH) initiated the Hospital Levels of Care Task Force. Its goal was to ensure that all pregnant patients deliver at a hospital that could provide a risk-appropriate level of care. Because Indiana did not have a formal process for designating levels of care for the state’s 90 birthing hospitals, the Task Force was asked to 1) assess the current level of care definitions; 2) create standard definitions and guidelines for each hospital level of obstetric and newborn care, and 3) make recommendations to the health department and professional organizations on policy needed to improve quality perinatal care and what the next steps should be. The Task Force adopted principles to guide its work:
- Achieve the best outcomes for mothers and babies;
- Comply but not exceed the American Academy of Pediatrics (AAP) and American Congress of Obstetricians and Gynecologists (ACOG) national standards;
- All standards must be grounded in solid evidence;
- Produce a visionary document.
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In 2012, the Task Force finalized its recommendations that incorporated AAP and ACOG Guidelines for Perinatal Care that were published in September 2012. A gap analysis was conducted with all Indiana hospitals with obstetric and newborn services to support a self-assessment of their current status compared to the national guidelines. Forty-three percent (43%) of the obstetric units and 32% of the newborn units met the revised guidelines for their self-declared level of care. Based on the results of the survey and the work of the Task Force the MCH Director was charged to build on the work that began with the Levels of Care Task Force (2011-2012). The Indiana Perinatal Quality Improvement Collaborative (IPQIC) began its official work in 2013. The vision of IPQIC is:
- All perinatal care providers and all hospitals have an important role to play in assuring all babies born in Indiana have the best start in life.
- All babies in Indiana will be born when the time is right for both the mother and the baby.
- Through a collaborative effort, all women of childbearing age will receive risk-appropriate health care before, during and after pregnancy.
While there have been changes since IPQIC was created, the commitment to reduce infant mortality as well as morbidity remains unchanged. The current IPQIC infrastructure involves nearly 450 stakeholders participating in this significant effort to address the issues of infant mortality and morbidity. A few of the successful efforts to date include:
- the adoption of Levels of Care rules for Indiana birthing hospitals in 2019;
- The implementation of three toolkits – Perinatal Substance Use, Maternal Hemorrhage and Hypertension;
- Breastfeeding guidance documents related to safe sleep, reproductive planning and substance use; and
- Perinatal transport guidelines and conferences
In 2021, IPQIC engaged in a strategic planning process to identify priorities for the next three-year cycle. Comprehensive data were reviewed, and a new set of goals were established moving into the future:
Goal I: Ensure all women of childbearing age in Indiana have access to comprehensive, trusted and risk-appropriate health care before, during and after pregnancy.
Goal II: Ensure that all Indiana parents and caregivers have access to the resources and support they need to ensure their infants thrive and celebrate their first birthday.
Goal III: All pregnant patients with substance use and/or mental health challenges have access to and receive risk-appropriate treatment and support services
Goal IV: All pregnant patients receive timely, high-quality, equitable and trusted prenatal care that results in an uncomplicated delivery and a healthy term baby.
Goal V: All parents receive the support and resources needed post-discharge to meet their individual needs and improve their opportunity to see their child’s first birthday.
New task forces have been added to existing ones to address the challenges and opportunities that were identified during the planning process. The chart below represents the infrastructure of IPQIC and the priorities established for 2022-2024.
The completed work and ongoing activities of IPQIC are designed to complement the continuing efforts of the Indiana Department of Health (IDOH) to improve outcomes for Indiana’s mothers and babies. The work of IPQIC is focused on both maternal and neonatal mortality and morbidity issues as well as emerging issues that often result in additional task forces and workgroups. IPQIC and its members remain committed to supporting the efforts of IDOH in working actively to promote quality outcomes for Indiana mothers and their babies.
- Breastfeeding and Reproductive Planning Consumer Information Chart (Spanish version)
- Breastfeeding and Reproductive Planning Guidance Document
- Breastfeeding and Safe Sleep Guidance Document Updated December 2020
- Breastfeeding and Substance Use Guidance Document
- Breastfeeding and Substance Use Traffic Light (Spanish version)
Perinatal Centers Task Force
Women's Health Task Force
- LARC Resource Guide 2021
- Medically Indicated Inductions Guidance Updated 2021
- Trauma Informed Care Position Statement 2023
Perinatal Transport Task Force
- Governing Council Reports
- Task Force Reports
IPQIC Quality Improvement Task Force
- Addressing Infant Mortality White Paper
- Recommendations to Improve the Accuracy and Quality of Indiana Birth and Death Certificates
- Progesterone to Prevent Prematurity Recommendations
- Decreasing Sudden Unexpected Infant Deaths in Indiana
IPQIC Perinatal Substance Use Task Force
- 2023 PSU Survey Report
- NAS: Providing Family-Centered Care (October 2018)
- Perinatal Substance Use Practice Bundle
- 2014 NAS Report to the Legislature
IPQIC Finance Task Force
- The Economic Burden of Perinatal Morbidity UPDATED December 2020
- Economic Burden of Infant Morbidity Infographic UPDATED December 2020
- Payment Innovation/Reimbursement Strategy (LARC) UPDATED 2020
- Social Impact Bonds Report
IPQIC Data Committee
IPQIC Data Committee
Reproductive Health Planning Task Force