MMRP ECHO Perinatal Case Conference Series (CME accredited)

The Maternal Mortality Review Panel (MMRP) ECHO -- Supporting and training primary care clinic members

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The MMRP ECHO (Extension for Community Healthcare Outcomes) series is for Washington State providers. The 9-session CME accredited* program addresses risks of mortality and provides education to improve care for perinatal patients. ECHO presentations are held each month on Tuesdays. They will include components that guide evaluation of the severity of any identified risk, preparation of a risk mitigation plan, and initiation of a team-based care approach within the care setting. Participants will learn to address causes of maternal mortality as identified in the 2023 Maternal Mortality Review Panel report (below).

2023 Maternal Mortality Review Panel
Report to the Legislature

Who should attend?

• Any clinician providing primary care to pregnant and parenting individuals - including advance practice clinicians, family medicine physicians, and family medicine residents
• Staff - including intake coordinator, care coordinator, clinic manager, etc.

Attend the June 20 Session
Expert Guest Panelist Lisa Galbraith Will Join Ian Bennett to Present: 

Quality Improvement Efforts to Reduce the Leading Causes of Maternal Mortality and Morbidity

Lisa Galbraith, DO, MPH, is an Obstetrician/Gynecologist practicing as an OB Hospitalist at Multicare Yakima Memorial Hospital. She was a National Health Service Corp Scholar interested in working in a rural/underserved area. She graduated from Lake Erie College of Osteopathic Medicine and did her residency training at Arrowhead Regional Medical Center in Southern California before moving to Washington State to work in the Yakima Valley. She has practiced in the Yakima Valley for the past 13 years. She has a Master’s of Public Health and has always been interested in and involved in Quality Improvement Projects to help improve patient care and safety.

Upcoming Case Conference Sessions

Quality Improvement Efforts to Reduce the Leading Causes of Maternal Mortality and Morbidity  |  June 20, 2023

Our expert guest panelist

 

Lisa Galbraith, DO, MPH, is an Obstetrician/Gynecologist practicing as an OB Hospitalist at Multicare Yakima Memorial Hospital.  She was a National Health Service Corp Scholar interested in working in a rural/underserved area.  She graduated from Lake Erie College of Osteopathic Medicine and did her residency training at Arrowhead Regional Medical Center in Southern California before moving to Washington State to work in the Yakima Valley.  She has practiced in the Yakima Valley for the past 13 years.  She has a Master’s of Public Health and has always been interested in and involved in Quality Improvement Projects to help improve patient care and safety.

Pre-assignment

More information coming soon

 

 

Goals for participants

At the end of the session participants will be able to:

• Learn Quality Improvement (QI) methods to address contributing factors and identify gaps in causes of maternal mortality
• QI methods to improve risk assessment to reduce maternal mortality 
• QI methods to improve care coordination and continuity of care to reduce maternal mortality

Past Sessions

Maternal Mortality in Priority Populations - Social Determinants of Health and Other Social Inequities  |  May 16, 2023

Our expert guest panelist

Carl Olden is a Family Physician practicing Obstetrics in Yakima since 1984. A Washington native, he grew up on the Yakama Indian Reservation and is a citizen of the Confederated Tribes and Bands of the Yakama Nation. He graduated from the University of Washington School of Medicine, did Residency Training in Family Medicine at the Oregon Health and Sciences University, and practiced for 11 years with the US Public Health Service at the Yakama Indian Health Center before joining the faculty of the University of Washington Family Medicine Residency Network at Central Washington Family Medicine where he was the Obstetrical Coordinator. In 1998 he founded Pacific Crest Family Medicine, his current group practice. He has been the International Board Chair for the AAFP Advanced Life Support in Obstetrics Program, helping to spread this maternity emergency care and patient safety program throughout the world, personally traveling to 25 countries to initiate courses. He has been the President of the Washington Academy of Family Physicians, the President of the Washington State Obstetrics Association, a 4-year member of the Board of Directors of the American Academy of Family Physicians, a member of the Washington State Maternal Mortality Review Panel, Washington's representative to the CDC MMRP, a charter member of the Robert Bree Collaborative where he has chaired a number of obstetrical care process and payment reform work groups, and a charter member of OB COAP, where he currently serves as the Chair of the Management Committee.

Pre-assignment

If you have an opportunity, please review one or more of the items below prior to our case conference session.

• Maternal Health Care in Rural Communities
• AHIP IB Maternal Value-Based Care
• Birth Settings in America: Outcomes Quality Access and Choice 2020
• Maternal Health Blueprint
• Dwyer Racial and Ethnic Disparities
• Pregnancy-Related Deaths - AIAN Data
• MMRCs 2017-2019
• Disparities in Preeclampsia stratified by race and income
• CMS Maternity Care Action Plan

Goals for participants

At the end of the session participants will be able to:

• Describe the social determinants that impact maternal mortality pregnancy and the year postpartum
• Learn tools and methods to address social determinants of health in their perinatal patient population to reduce risk of maternal mortality
• Review the process of iterative quality improvement to implement enhancements to address social determinant of health in the perinatal population

Co-morbidities and Maternal Mortality  |  April 25, 2023

Presenter

Ian Bennett MD, PhD

Goals for participants

At the end of the session participants will be able to:

• Describe the risk factors associated with co-morbidities (e.g., obesity) and maternal mortality
• Learn tools and methods to reduce the risk of obesity related maternal mortality 
• Review the process of iterative quality improvement to implement enhancements that improve care to reduce impact of co-morbidities on maternal mortality

Reducing Maternal Mortality Due to HELLP Syndrome  |  March 21, 2023

Our expert guest panelist

Catherine Albright MD, MS

Dr. Albright is an associate professor in the division of Maternal-Fetal Medicine at the University of Washington.  Her clinical and research interests are related to medical complications of pregnancy, especially cardiac disease and hypertension.  She is the director of the Hypertension in Pregnancy Program and the co-director of the Cardio-Obstetrics Program at UW.  She has served on the Washington State Maternal Mortality Review Panel since 2020 and truly enjoys the multi-disciplinary nature of that work. 

 

 

 

 

 

 

 

 

 

Goals for participants

At the end of the session participants will be able to:

• Describe risk factors associated with HELLP syndrome and maternal mortality
• Learn tools and methods to reduce HELLP syndrome risk as cause of maternal mortality
• Review the process of iterative quality improvement to implement enhancements to address HELLP syndrome of maternal mortality

Reducing Maternal Mortality Due to Eclampsia  |  February 21, 2023

 Our expert guest panelist

Pre-assignment

If you have an opportunity, please review prior to our case conference session.

• Maternal Mortality from Preeclampsia/Eclampsia, Sibai, 2012

Goals for participants

At the end of the session participants will be able to:

• Describe risk factors associated with eclampsia and maternal mortality
• Learn tools and methods to reduce eclampsia risk as cause of maternal mortality
• Review the process of iterative quality improvement to implement enhancements to address eclampsia causes of maternal mortality

Reducing Maternal Mortality Due to Pre-eclampsia  |  January 17, 2023

Goals for participants

At the end of the session participants will be able to:

• Describe risk factors associated with pre-eclampsia and maternal mortality
• Learn tools and methods to reduce preeclampsia risk as cause of maternal mortality
• Review the process of iterative quality improvement to implement enhancements to address pre-eclampsia causes of maternal mortality 

Our expert guest panelist

Catherine Albright MD, MS

Dr. Albright is an associate professor in the division of Maternal-Fetal Medicine at the University of Washington.  Her clinical and research interests are related to medical complications of pregnancy, especially cardiac disease and hypertension.  She is the director of the Hypertension in Pregnancy Program and the co-director of the Cardio-Obstetrics Program at UW.  She has served on the Washington State Maternal Mortality Review Panel since 2020 and truly enjoys the multi-disciplinary nature of that work. 

Related Resource

Preeclampsia Foundation

 

 

 

 

 

 

 

Reducing Maternal Mortality Due to Hemorrhage  |  December 20, 2022

Goals for participants

At the end of the session participants will be able to:

• Learn sources of hemorrhage causes of maternal mortality (cervical laceration, ectopic pregnancy, uterine rupture)
• Learn tools and methods to reduce risk of hemorrhage as a cause of maternal mortality
• Review the process of iterative quality improvement to implement enhancements that address maternal mortality due to hemorrhage in the perinatal population

Our expert guest panelist

Lacey R. Miller, DNP, CNS, APRN, RNC-OB, C-EFM
Perinatal Clinical Nurse Specialist, Legacy Health, Family Birth Center Services
MMRP Lead for Quality and Patient Safety

Lacey Rose Miller is a perinatal clinical nurse specialist currently working at a hospital system with six family birth centers in the Portland, Oregon metropolitan area. Her background at the bedside consists of high-acuity and high-volume labor, delivery, obstetric operating room, recovery, and postpartum nursing care. Her graduate education from the University of Washington, afforded her a Doctor of Nursing Practice degree as a perinatal clinical nurse specialist, and a Global Health Graduate Certificate specializing in Women, Children and Adolescents. In her current role, she loves to collaboratively work on practice improvement projects that improve the outcomes of families and newborns, and she loves to support nurses caring for clinically complex patients. She is the current Legislative Coordinator for the Washington State Section of the Association of Women’s Health, Obstetric and Neonatal Nurses. She proudly serves on the Washington State Maternal Mortality Review Panel as their Lead member in Patient Safety and Quality Improvement. Lacey is a mother of two young children. If she finds free time, she’ll want to spend it in her garden, on a bike, or deep in a Pacific Northwest forest.

Stigma and Bias Related to Behavioral Health Conditions and Perinatal Suicide Risk  |  November 22, 2022

 Goals for participants

At the end of the session participants will be able to:

• Learn tools and methods to address and lower stigma and bias related to behavioral health conditions in their perinatal patient population
• Identify the immediate internal actions and external resources to lower stigma and bias
• Understand best practices to lower stigma and bias related to behavioral health conditions in perinatal population 

Pre-assignment

If you have an opportunity, please review documents and videos below prior to our case conference session.

• Maternal self-harm deaths: an unrecognized and
  preventable outcome
• Trying to Do What Is Best: A Qualitative Study of Maternal-Infant
  Bonding and Neonatal Abstinence Syndrome
• https://youtu.be/eZ0CafocLsY
• https://youtu.be/YS3V4hFxIIU 
• https://youtu.be/ZHa-zKIB38Q
• https://youtu.be/ktOeFgmdIAo

Our expert guest panelist

Dr. Charissa Fotinos joined the Washington State Health Care Authority in October of 2013 as the Deputy Chief Medical Officer in support of the Apple Health/Medicaid programs. In August of 2021, she was named the Acting Medicaid Director, and in June of 2022 she was named the permanent Medicaid Director and Behavioral Health Medical Director. She is actively involved in behavioral health integration efforts with a particular focus on improving the access to and care of persons with substance use and mental health disorders. She is a co-sponsor of the Washington State Opioid Response Plan.

Prior to her current position, Dr. Fotinos was the Chief Medical Officer for Public Health Seattle-King County. 

Dr. Fotinos is board certified in Family and Addiction Medicine. Before joining Seattle-King County, she was a physician-faculty member at the Providence Family Medicine Residency in Seattle, Washington.

She holds a Master of Science degree in evidence-based health care from Oxford University, Kellogg College, in England and is a Clinical Associate Professor at the University of Washington in the Department of Family Medicine.

 

Pregnancy-Associated Deaths Due to Accidental Substance Overdose  |  October 18, 2022

Goals for participants

At the end of the session participants will be able to:

• Learn tools and methods to address and lower accidental opioid overdose in their perinatal patient population
• Implement improving screening and initial risk assessments for substance use among patients in the perinatal period 
• Identify patients in the perinatal period that should have access to and training in the use of Naloxone rescue kit 
• Describe treatment options for Opioid Use Disorder in the perinatal period

Our expert guest panelist

Nadejda Bespalova MD, Dept of Psychiatry and Behavioral Sciences, University of Washington

Pre-assignment

Before the session please review: 

• Register and view webinar #2, recorded 9/22/21: Pregnancy-Associated Deaths Due to Accidental Opioid Overdose (CME accredited)

Perinatal Suicide Risk  |  September 20, 2022

Goals for participants:

• Learn tools and methods to address and lower suicide risk in their perinatal patient population
• Describe the risk factors associated with death by suicide in pregnancy and the year postpartum
• Understand best practices for follow-up and expectations for progress after a positive screen
• Assess the acute risk of self-harm using the Columbia Suicide Severity Rating Scale (CSSRS)

Pre-assignment

Before the session please review:

• Register and view Webinar #1, recorded September 15, 2021 (CME accredited) 
• Read the MMRP Report

*CME Accreditation

​The University of Washington School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

​The University of Washington School of Medicine designates this live activity for a maximum of 9 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. (Each session is 1.0 credit)

Disclosure: The regular presenters and program planners of this case conference have disclosed that they have no relevant financial relationships with commercial interest(s).