Clinical Practice: AIM to Prevent Maternal Mortality and Morbidity

It’s no secret that the US has one of the highest maternal morbidity and mortality rates in the modern, industrialized world. In fact, a recent study in ACOG’s Green Journal sparked the latest national conversation (with Texas at the epicenter) about why we fail to reduce these numbers.

The reality is—improving maternal health outcomes requires strong leaders, an engaged team, and a data-driven, evidence-based approach.

To combat maternal mortality and morbidity, ACOG leads the Alliance for Innovation on Maternal Health (AIM), an open-access, collaborative program based on proven approaches to improve maternal safety in all US birth hospitals. AIM utilizes rapid-cycle and continuous quality improvement strategies in conjunction with a team-based approach to help hospitals improve their readiness and response to emergency obstetric events. As ob-gyns, we have a unique opportunity as maternity care team members to influence and lead efforts at the hospital level. Not only can we help prevent severe maternal events at childbirth, but we can also save lives.

How AIM Works

AIM provides hospitals with implementation resources to help them prepare for and respond to obstetric emergencies, which will ultimately improve overall maternal health outcomes in their state.

Focusing on the four R’s of patient safety bundles—readiness, recognition, response, and reporting—AIM provides implementation support and data collection plans for the following Patient Safety Bundles and Tools:

As an AIM member, you will also have access to a growing community of multidisciplinary health care providers, public health professionals, and cross-sector stakeholders that connect regularly to share their experiences and provide helpful suggestions on how to implement patient safety bundles more effectively. AIM provides ongoing technical assistance to ensure knowledge sharing across hospitals and states.

AIM also offers your hospital the ability to track your maternal safety and quality improvement efforts through the secure and centralized AIM Data Center. The AIM Data Center provides timely tracking of outcome, process, and structure data measures to ensure you are effectively reducing maternal morbidity and mortality outcomes at both the hospital and state level.

A Nurse’s First-Hand Experience with AIM

Beth McGovern, RNC-B, MSN, is a clinical practice specialist for Women's and Children's Services at Valley Hospital in Ridgewood, New Jersey. When she and her colleagues heard of the “AIM e-Learning Module on Maternal Early Warning Signs (MEWS),” they discussed the benefits of having such protocols in their labor and delivery unit. A multidisciplinary perinatal committee subgroup developed a hospital-specific MEWS protocol, then staff education and trainings were conducted. Implementation of MEWS in the labor and delivery unit at Valley Hospital was officially rolled out in March 2015.

MEWS protocols proved beneficial for labor and delivery staff at Valley Hospital and have proven effective in reducing maternal morbidity. For example, a mother who had delivered her baby the previous day began showing symptoms of severe hypertension. The notation of MEWS status signs in her EMR led to action. Immediately, the patient was treated, transferred from the postpartum floor to the labor and delivery unit, and eventually to the intensive care unit where her blood pressure was controlled. Ultimately, she was able to go home with her newborn.    

The implementation of MEWS protocols has received positive feedback from nurses and labor and delivery staff at Valley Hospital. It is user-friendly and has improved the quality of teamwork. “Nurses are seeing validity and they absolutely love it,” says McGovern. “They’re able to have women assessed for critical conditions in a timely manner, which reinforces the culture of safety within our hospital.” McGovern concludes, “Anybody can take these criteria and have it tailored to fit their institution.” Given physicians’ concerns about being called too frequently for emergencies, resulting in alarm fatigue, following MEWS protocol ensures labor and delivery staff are consistently prepared to face situations that could result in maternal mortality or morbidity. 

Learn more about MEWS

Team up with AIM

Contact us to get involved.

AIM Core Partners

AIM is proudly supported by a large network of leading women’s health care and public health advocates, including:

American College of Obstetricians and Gynecologists (ACOG)

American College of Nurse-Midwives (ACNM)

Association of Maternal & Child Health Programs (AMCHP)

Association of State and Territorial Health Officers (ASTHO)

Association of Women’s Health Obstetric and Neonatal Nurses (AWHONN)

California Maternal Quality Care Collaborative (CMQCC)

Society for Maternal-Fetal Medicine

AIM is funded by Grant #UC4MC28042 through a cooperative agreement with the Maternal and Child Health Bureau (MCHB) and Health Resources & Services Administration (HRSA).

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998