The MNO-OB sustainability phase began in January 2021, where participating facilities worked to track compliance and develop plans for missed quality improvement opportunities. During the same period, the percentage of patients with OUD who were connected to medication for opioid use disorder by delivery discharge and linked to recovery treatment services increased from 41% to 76% and 48% to 70%, respectively, and the percentage of patients with OUD who received Narcan counseling increased from 2% to 63%. Over the course of the initiative, the percentage of sampled pregnant patient records with documentation of a validated screening tool used on Labor & Delivery increased from 3% in Q4 of 2017 to 85% in Q4 of 2020. The Illinois Perinatal Quality Collaborative (ILPQC) launched the Mothers and Newborns affected by Opioids – Obstetric (MNO-OB) Initiative in May 2018 based on AIM’s Obstetric Care for Women with Opioid Use Disorder (OUD) patient safety bundle with all 101 of the state’s birthing facilities.
In 20, mental health conditions, including substance use disorder, were the leading causes of pregnancy-related deaths in the state. The NYSPQC continues to lead the NYS OUD in Pregnancy & NAS Project with webinars, educational opportunities, data collection and analysis, resource distribution, and clinical and quality improvement support. The percentage of birthing people with OUD who received medication for opioid use disorder or behavioral health treatment during pregnancy increased from 72% to 93%, as reported by pilot phase facilities, and increased from 85% to 94%, as reported by expansion phase facilities. The percentage of facilities that implemented a universal screening protocol for OUD increased from 21% in January 2019 to 73% in December 2021 among the 14 facilities participating in the pilot phase and from 33% in December 2020 to 86% in December 2021 among the 25 facilities participating in the expansion phase. The project has since expanded to include a total of 39 birthing facilities. The project began as a pilot in September 2018 with 14 birthing facilities participating and submitting data. In response, the New York State Perinatal Quality Collaborative (NYSPQC) implemented the New York State (NYS) Opioid Use Disorder (OUD) in Pregnancy & Neonatal Abstinence Syndrome (NAS) Project based on the AIM Obstetric Care for Women with OUD patient safety bundle. In New York, the rate of opioid overdose deaths for women aged 18-44 tripled between 20.
Long-term outcomes for birth parents and infants will continue to be assessed through other programs. During the same period, the proportion of opioid-exposed newborns ≥35 weeks’ gestation who received any of their parent’s milk at discharge increased from 56% to 65%, representing a 16% increase. Among the MBSEI Collaborative hospitals, the proportion of pregnant people with OUD who received medication for opioid use disorder or behavioral health treatment increased from 45% in January 2019 to 58% in December 2020, representing a 29% increase. Participating facilities identified and implemented best practices in areas including screening, treatment, transitions in care, and education for OUD.
These facilities represented 14% of live births in the state. Between July 2019 and September 2020, the California Maternal Quality Care Collaborative engaged 27 birthing facilities located in counties with high rates of neonatal abstinence syndrome to participate in its mother & Baby Substance Exposure Initiative (MBSEI) Collaborative based on AIM’s Opioid Use Disorder (OUD) patient safety bundle.
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