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2023 Annual

Report

TIPQC seeks to promote meaningful change, advance health equity, and improve the quality of care through pregnancy, delivery, and beyond for all Tennessee families.

Letter from the Chair of the oversight committee
oversight committee
Operations staff
Continued Leadership in Projects
results
Impact Stats

Letter from the Oversight Committee Chair

I grew up in New Jersey and I have fond memories of going to the “Jersey shore”, especially to Ocean City. The boardwalk there was a great attraction, sparing you from the heat of an August day as you found respite from the sun in pizza and salt-water taffy. For me, the boardwalk at night kept me mesmerized, especially the arcades. Though pinball machines were still the rage then, I loved a different kind of arcade game. Standing in front of a surface with myriad holes in it, you stood with a rubber mallet in your hands in anticipation for “whack-a-mole” to begin. It was a great way to relieve your frustrations of the day as little furballs popped up and down, scoring with every successful “whack.” Ah, summer!

As I reflect on 2023, I’m reminded of the ways in which fighting morbidity and mortality in infants and pregnant persons feels like whack-a-mole. You hope that the latest project is going to be the solution, enabling each Tennessee baby-caregiver dyad to leave the hospital safe and healthy, followed by a birthday cake enjoyed by all a year later. We approach the project with a plan for implementing best practices, collecting the data, refining the process, and making sustained progress. And it feels soooo satisfying to make progress!

But as we see from the 2023 Maternal Mortality Report, rates of maternal mortality are increasing across the United States. Though the Infant Mortality Report is not yet out for Tennessee, I think we are all bracing for an increase given the US data. As my good friend Dr. James Greenberg at Cincinnati Children’s Hospital Medical Center discussed one of our 2023 Podcasts, maternal and infant mortality are “wicked problems.” No matter how hard you work to fix one aspect – one furball on the whack-a-mole table – a new one (or a new “old one”) pops up.

So why do we keep coming back to the next project as well as gatherings such as the Annual Meeting in the face of what seems relentless? That’s easy…it’s because it’s the right thing to do. We are healthcare providers, with an emphasis on health. It’s in our nature to restore health and prevent disease, and our patients are counting on us. When you make progress on a TIPQC project, a patient or dyad received evidence-based practices that weren’t available or consistently provided before.

In 2023:

  • 61,642 babies in Tennessee received optimal cord clamping
  • 786 preemies were in the intraventricular hemorrhage project, with a 45-46 % reduction in sIVH, with data from Waves 1 & 2 through the mid-term of the project
  • 74% of birthing hospitals covering 82% of all births, participated in at least one of these projects

Each of these 2023 successes may not be reflected in our IMR/MMR data for Tennessee, but I guarantee you that the important thing for that family is that first birthday party that will happen in 2024. We may not be able to clear the table with one rubber mallet, but working together in our individual hospitals and collectively across the state we can confront the causes of infant and maternal mortality and systematically do the right thing each day in the service of our patients.

With deep admiration for the work you do with us,

Board of Directors, Chair

SUSAN GUTTENTAG, MD

“ TIPQC has changed the culture of clinical care among all neonatal-perinatal providers in TN. It has brought together, physicians, NPs, nurses and other staff to improve quality of care and outcomes of mothers and newborns in all settings.”

Ajay J. Talati, MD

“Our partnership with TIPQC enables us to actualize statewide recommendations to prevent maternal and neonatal deaths through quality improvement projects. TIPQC prioritizes projects that move the needle on decreasing preventable maternal and neonatal morbidity and mortality in Tennessee.”

Assistant Commissioner Elizabeth Harvey, PhD, MPH

Oversight Committee

The Oversight Committee is critical to the work of TIPQC. Special thanks for their contribution to improved care for mothers and infants in Tennessee.

Tobi Amosun, MD, FAAP, Deputy Commissioner for Population Health, Tennessee Department of Health

Jona Bandyopadhyay, MD, MPH, FACOG, Associate Medical Director, TennCare

Andrea Johnson, MD, Assistant Professor in Obstetrics and Gynecology, Vanderbilt University Medical Center

Greg Cannella, MD, TN Medical Director, Government Business Division, Amerigroup

Sharon Moore-Caldwell, MD, MDiv, Medical Director, BlueCross BlueShield, BlueCare, TN

Mary Catherine Burke, DMCP, Parent Representative, Director, Special Events, Regional One Health Foundation

Tara M. Burnette, MD, Neonatologist, University of Tennessee Medical Center, Knoxville

Chris Clarke, RN, BSN, Senior Vice President, Clinical Services, Tennessee Hospital Association

Lilly Cooper, MSN, RN, NE-BC, Director Nursing Administration, Regional One Health

Melissa Davis, DNP, CNM, FNP, TN Chapter of ACNM, Vanderbilt School of Nursing

Camielle Fishel, DNP, MSN, BS, RNC-OB, Director of Nursing, Baptist Memorial Hospital for Women

Cornelia R. Graves, MD, FACOG, Medical Director, Tennessee Maternal Fetal Medicine Director of Perinatal Services, St. Thomas Health Clinical Professor, Vanderbilt University Adjunct Professor, Meharry Medical College Professor, University of Tennessee

Susan H. Guttentag, MD, Julia Carell Stadler Professor of Pediatrics Vanderbilt School of Medicine Director, Mildred Stahlman Division of Neonatology Monroe Carell Jr. Children’s Hospital at Vanderbilt PI & Oversight Committee Chair, TIPQC

Brian Hackett, MD, PhD, Professor of Pediatrics, Vanderbilt University Medical Center

Elizabeth Harvey, PhD, MPH, Assistant Commissioner and Director of the Division of Family Health and Wellness at the Tennessee Department of Health

Joseph Kipikasa, MD, Vice Chair and Residency Program Director of University of Tennessee Department of Obstetrics and Gynecology, Chattanooga Unit

Melanie Morris, PhD, APRN, WHNP-BC, CCE, AWHONN TN Section Chair

Diana Moses, RN, BSN, MBA, Senior Director of Neonatal & Pediatric Programs, HCA Corporate

Tiffany Peggs, MD, Chief Medical Officer, UnitedHealthcare Community & State

Shannon Rigler, MD, Medical Director of Neonatology, Erlanger Children’s Hospital

Jack Owens, MD, MPH, Neonatology Division Director East Tennessee State University/NICU Medical Director Niswonger Children’s Hospital

Ajay Talati, MD, Sheldon B. Korones Professor and Chief, Neonatology, Professor, Pediatrics and OB/GYN, Vice-Chair for Education, Pediatrics, Program Director, Neonatal-Perinatal Medicine

Kerri Brackney, MD, Maternal Fetal Medicine, Regional One Health

Kevin Visconti, MD, Maternal-Fetal Medicine, High Risk Obstetrical Consultants

Lynlee Wolfe, MD, Assistant Professor, Maternal and Fetal Medicine, University of Tennessee Medical Center

Victor Wu, MD, MPH, Chief Medical Officer, Division of TennCare

________________________________________

Ex-Officio Brenda Barker, M Ed, MBA, TIPQC Executive Director

Ex-Officio Scott Guthrie, MD, FAAP, TIPQC Past Infant Medical Director

Ex-Officio Karen Schetzina, MD, MPH, FAAP, TIPQC Infant Medical Director

Ex-Officio Danielle Tate, MD, MBA, TIPQC Maternal Medical Director

Ex-Officio Jessica Young, MD, MPH, Past TIPQC Maternal Medical Director

Ex-Officio Rolanda Lister, MD, TIPQC Health Equity Officer

Sub Committee Members:  

Maintenance of Certification (MOC):  Tara Burnette, MD & Donna Whitney, MD

Engagement Committee:  Marlee Crankshaw, DNP, RN, CNML, Melanie Ford, RNC, Deena Kail, BSN, RN, MBA

TIPQC Operations Staff

The TIPQC Infant and Maternal Medical Directors as well as the Quality Improvement (QI) Nursing Specialists provide expertise, passion, and knowledge to all the work of TIPQC.  The core team also includes QI, project, and data management expertise.

Read more

“This past year TIPQC has seen another impressive year of successes and advancement in quality improvement work across the state. The Promotion of Safe Vaginal Deliveries Project officially kicked off in March and saw renewed enthusiasm as 37 teams committed to prioritizing work in this area to lower Cesarean Delivery rates. With this, we were able to connect hospitals to invaluable and innovative resources, including Teambirth, Spinning Babies, and the Lactation Workforce, to aid in success. In addition, TIPQC was able to take simulation training on the road and provide training and support across the state, including to first responders, which was a great feat. I am very grateful to the continued dedication and hard work of all of our providers and hospital teams, and the continued support from all of our healthcare partners. I am looking forward to the great things that are to come in 2024”.

Danielle Tate, MD, MBA, Maternal Medical Director

“I’ve always been impressed at how many different improvement projects TIPQC develops, launches, and sustains so effectively year after year. Having the opportunity to participate in the National Network of Perinatal Quality Collaboratives (NNPQC) meeting in Denver this year helped me realize the extent to which Tennessee is leading the nation in this work. PQCs from other states were looking to Tennessee for ideas and solutions.”

Karen Schetzina, MD, MPH, Infant Medical Director

“Energized, committed, and dedicated” are a few words that describe the hospital improvement teams! Having added a greater patient and partner voice this year has also contributed to additional insights and improvement opportunities. TIPQC continues to be amazed by each individual contribution in making our care for our moms and babies the best it can be- for all of us!”

Brenda Barker, MEd, MBA

Continued Leadership and Vision with Quality Improvement Projects

Over the past 15 years, TIPQC continues to develop high quality improvement projects to support the work of the local hospital teams, including community and patient partners and many other stakeholders.

At the Annual Meeting, future projects are discussed, with “straw poll voting” indicating potential projects which are calibrated for development based on state data and other trending concerns, best practices, and state, national, and international resources.

State Project leaders are selected based on expertise and have included this year:

Optimal Cord Clamping:

Scott Guthrie, MD

Howard Herrell, MD

Patti Scott, DNP, APN, NNP-BC, C-NPT

Danielle Tate, MD, MBA

Bonnie Miller, RN, MSN

Brenda Barker, MEd, MBA

Intraventricular Hemorrhage:

Scott Guthrie, MD

Marcelo Rains, MD

Parul Zaveri, MD

Patti Scott, DNP, APN, NNP-BC, C-NPT

Brenda Barker, MEd, MBA

Promotion of Safe Vaginal Delivery:

Danielle Tate, MD, MBA

Cornelia Graves, MD

Bonnie Miller, RN, MSN

Brenda Barker, Med, MBA

Anastacia Volz, MPA

Lactation Taskforce

Brenda Barker, MEd, MBA

Ginger Carney, MPH, RDH, LDN, IBCLC, RLC, FILCA, FAND

Gloria Dudney, RN, IBCLC, RLC

Briana J. Jegier, PhD

Tiana Pyles, MHA, CLC

Karen Schetzina, MD, MPH, FAAP

Pat Steimer, RN, IBCLC

Genae Strong, PhD, APRN, CNM, RNC-OB, IBCLC, RLC, CNE

Real Results: Projects & Impact

The Optimal Cord Clamping project with 26 hospital teams, worked during 2022-23 to attain The World Health Organization recommendation that at birth neonates receive at least 60 seconds of placentally transfused blood before the umbilical cord is clamped.  Benefits to the infant include reducing morbidity and mortality, improving neurodevelopmental outcomes, reducing the incidence of late onset sepsis, reducing the need for blood transfusions, and reducing the need for hypotension treatment.

In the final analysis, 61,642 infants or 83% of those born in participating hospitals received optimal cord clamping. Teams saw a 10% improvement that should lead to a 5% decrease in mortality.

Twelve (12) hospitals achieved a 5-star rating, which consisted of active project participation including huddles and coaching calls, monthly outcome and structure data capture, data driven QI work, clinical change implementation, and reaching the state goal of 90% of infants receiving optimal cord clamping.  Five (5) hospitals achieved a 4-star rating, which consisted of successful completion of 4 of the 5 following project expectations: active project participation including huddles and coaching calls, monthly outcome and structure data capture, and data driven QI work.

“Working on the OCC project and TPIQC has been an amazing experience and seeing the impact on the lives of Tennessee’s tinyiest babies has been very rewarding.

Howard Herrell, MD, State OB leader

61,642 lives impacted and improved by this project! TIPQC and all the hospitals and staff who participated knocked this one out of the park! Great job!”

Scott Guthrie, MD State Leader

For more on this project, see: https://tipqc.org/occ/ and the Impact Statement.

The Promotion of Safe Vaginal Delivery (PVD) project

The Promotion of Safe Vaginal Delivery (PVD) project, started with the 6 pilot hospitals in October 2022, with all 36 teams joining by June 2023 to promote safe vaginal delivery for the Nulliparous, Term, Singleton, Vertex Pregnancy (NTSV) thus decreasing the rate of C-Sections to the Healthy People Goal 2030 of <23.6%. 

Nationally, Tennessee is in the highest quartile of cesarean birth rates at 34.2%.  Based on 2015-2019 Tennessee Department of Health Vital Statistics data, 75% of TN hospitals have a cesarean birth rate above 20%.  There is notable variation in cesarean birth rates among the birthing hospitals in Tennessee, with 31 percentage points separating the facilities with the highest and lowest cesarean rates.  According to LeapFrog data, the rate of cesarean births among nulliparous, term, singleton, vertex (NTSV) pregnancies range from 11% to 42% among responding TN birthing hospitals.

This project has 11,668 NTSV deliveries in the participating hospitals to date.  Of these deliveries, there were 3,220 cesarean births, as well as 6,536 NTSV after labor induction, with 1,837 having a cesarean delivery.

This is an ongoing project, but much work as been done!  Mid-term Impact Statement

For more on this project, see:  Project – Promotion of Safe Vaginal Deliveries

The Intraventricular Hemorrhage (IVH) project

The Intraventricular Hemorrhage (IVH) project included all twelve (12) of the Level 3 & 4 NICUS in the state, and is a part of the Tennessee Tiniest Babies bundle, with a total of 768 babies to date in this project.  Halfway through this project, the six pilot hospitals have seen a percentage decrease from 15.4% in December 2022 to 8.3% in September 2023.  These teams have a median value of 8.0% during these 10 months of participation, and an overall sIVH rate of 8.4%.  The six non-pilot hospitals have a decrease in the monthly sIVH percentage from 20% in April 2023 to 11.1% in September 2023.  These teams have a median value of 12% during 6 months of participation, and an overall sIVH rate of 12.2%. As a collaborative, the median sIVH rate is 9.4% and an overall sIVH rate of 9.8%. 

Midterm Impact Statement

“Tennessee’s Tiniest Babies got off to a great start with the severe IVH reduction project.  Looking forward to seeing how we impact Tennessee’s smallest citizens with what we are doing.”  Scott Guthrie, MD

“We are excited to partner together and provide statewide, collaborative, comprehensive care, to reduce the incidence of severe IVH in the state of TN. Let’s keep pushing forward to provide the best care we can.” Marcelo Rains, MD

“It is such great experience to be involved in the state wide IVH project and to learn about how different units across the state are working to optimize care of extremely preterm infants. Hope our collaborative efforts help us achieve our goal of reducing IVH rates in our preterm population.”  Parul Zaveri, MD

“Every baby is unique, but when we provide them with more consistent care, our outcomes improve. This project is making such an impact as we get to see more of our babies go home with fewer complications.”  John Buchheit, MD, East Tennessee Children’s Hospital

TeamBirth

TeamBirth is a joint project endeavor with TIPQC and Ariadne Labs supporting open communication among patients, their support people, and clinicians during birth. “Through structured huddles and a shared planning board, TeamBirth empowers everyone to reach decisions together. The result is more dignified, respectful care that gives patients the role that they want.”

The 5 hospital teams that began in November include Ascension St. Thomas Midtown, Baptist Memorial Hospital for Women, Regional One Health, TriStar Centennial Medical Center for Women, and TriStar Stonecrest Medical Center.  University of Tennessee Medical Center, Knoxville (previously implemented) has also joined as a mentor. 

Learn More About TeamBirth

Piloting: Chronic Lung Disease Project

Project was developed this Fall, with IRB approval received in December 2023. Piloting with state enrollment in the Spring 2024.  This is a continuation of the Tennessee Tiniest Babies bundle, which included the Optimal Cord Clamping Project and the current Intraventricular Hemorrhage Project.

Piloting: Cardiac Conditions in Obstetric Care Project

In conjunction with the Alliance for Innovation on Maternal Health (AIM), the TIPQC Faculty adapted the Cardiac Conditions in Obstetrical Care (CCOC) patient safety bundle, which received  IRB approval in December 2023.  The pilot will begin and state enrollment in the Spring of 2024. Cardiovascular disease (CVD) is the leading cause of maternal mortality in the United States, accounting for over one-third of all pregnancy-related deaths and is often associated with failure to provide timely risk-appropriate care.  According to the most recent Tennessee MMR, the leading cause of pregnancy related deaths was cardiovascular and coronary disease.  The goal of this project will be to implement cardiac screening in pregnancy in ALL hospitals that provide obstetrical care.

Piloting: Best For All Joint Project

Tennessee continues to have disparities in care related to race, education, and socioeconomic status in both maternal and infant outcomes. As a result, a respectful care joint project has been under development, as a learning collaborative, since August. After 23 faculty meetings, the tool kit, data collection tools, and application were completed, along with the IRB documents.  Approval was received February 26, 2024. Piloting, and statewide enrollment will commence in the Spring of 2024.

Sustainment:  Severe Maternal Hypertension Project

Sustainment:  Severe Maternal Hypertension Project: https://tipqc.org/tennessee-aim-severe-maternal-hypertension/ had a Sustainment Huddle in January. Continued work on hypertension is ongoing in these hospitals as well as the BabyScripts Pilot in Memphis.  Additional resources provided included AWHONN POST BIRTH Warning Signs Learning Seats to 43 hospitals, and refrigerator magnets for patients to 37 hospitals, and National Preeclampsia Foundation blood pressure cuff kits to 25 hospitals for 750 at-risk patients.

Learn More About SEVERE MATERNAL HYPERTENSION PROJECT

IMPACT

81

Level 1 & 2  Hospitals and Emergency Services Personnel received Simulation training in OB and Infant Emergencies

42 Hospitals (82% of births)

Involved in TIPQC Improvement Projects reaching 82% of all births

21,176

Podcast downloads

7,242

Unique listeners

61,642 infants or 83% of all infants in the project

Received Optimal Cord Clamping

50,395

Additional Postpartum Support International discharge brochures ordered for 45 hospitals

37

Hospitals received 58,495 magnets (English, Spanish, Arabic, Mandarin)

283

AWHONN Post Birth Warning Signs Learning Seats used by 43 hospitals

209

trained in Spinning Babies®

750

Preeclampsia Blood Pressure Cuff Kits purchased for 25 hospitals

18

Physicians earned 450 American Board of Pediatrics Maintenance of Certification (MOC) Credits & 3 Physicians Earned ACOG MSSP Credits

Resources

AWHONN’s POST BIRTH Warning Signs Learning Seats purchased for 45 hospitals included training for 10 nurses per hospital and discharge warning signs magnets & handouts for patients in 23 languages. An additional webinar with AWHONN national experts was held on January 19, 2023. In total, 283 AWHONN POST BIRTH Warning Signs Learning Seats used by 43 hospitals.  This training was extended for 2023 with the following hospitals completing the training:

  • Ascension St. Thomas Midtown
  • Baptist Memorial Hospital – Tipton
  • Baptist Memorial Hospital – Union City
  • Bristol Regional Medical Center
  • Erlanger Medical Center
  • Erlanger Children’s Hospital
  • Hardin Medical Center
  • Jackson-Madison County General Hospital
  • Newport Medical Center
  • Regional One Health
  • TriStar Northcrest Medical Center
  • Vanderbilt University Medical Center
  • West Tennessee Healthcare Volunteer Hospital

AWHONN POST BIRTH Warning Signs Magnets were purchased for 37 Hospitals needing 58,495 magnets (English, Spanish, Arabic, Mandarin) in 2023.  This is a total of 148,190 magnets for the 37 hospitals.

Post Partum Support International Magnets & Brochures

50,395 patient education Postpartum Support International (PSI) Brochures were printed for the requesting 45 hospitals (English and Spanish), along with the previous 107,640 PSI Brochures and 106,935 PSI Magnets previously disseminated totaling 265,970 total brochures and magnets supporting maternal mental health before and after delivery.

Preeclampsia Foundation Blood Pressure Cuff Kits

In 2023, an additional 750 Preeclampsia Blood Pressure Cuff Kits purchased for 25 hospitals to use with at-risk patients, thus totaling 3,959 kits for 34 hospitals to disseminate to pregnant and post-partum women.

BabyScripts (pilot)

Regional One Health was thrilled to pilot the BabyScripts platform from 2021 to 2023.  Through this technology, we were able to provide educational information digitally and conveniently. The remote monitoring program provided useful clinical information and allowed our providers to provide real-time medical attention based on remote blood pressure readings. Babyscripts provided insight into the number of sessions patients spent in the app as well as the top resources viewed. We were able to reach over 217 pregnant and  15 post-partum patients through the blood pressure screening as well as over 357 on the online education platform.

Educational opportunities

Summer Simulation Trainings (SIMS) were held across the state with OB emergencies and follow up emergency care for the infant.  81 Nurses, Educators, and EMS workers – which included 25 Level 1 & 2 hospitals and 8 EMS teams – attended the Summer SIMS training on OB and Neonatal emergencies, with presentations by TIPQC staff, Bonnie Miller, RN, MSN, Danielle Tate, MD, MBA and Patti Scott, DNP, APN, NNP-BC, C-NPT.  SIMS were held at Indian Path Community Hospital, Hardin Medical Center, St. Thomas Riverpark, and LeConte Medical Center.  Thank you to our hosts, trainers, and attendees for giving of your day(s) to train and prepare for these emergencies–we know the key to successful outcomes is preparation! 

Quotes from attendees

“Loved the hands-on experience with OB Emergencies and being able to talk through the SIMS as they were happening.”

“The instructors were great. Laid back learning environment, no judgement.”

“The scenarios were detailed yet low stress.”

“ I really learned a lot on how to conduct the training and to better my patient care.”

“Glad to have SIM resources to take back to my hospital.”

“Thank you so much!!  We enjoyed it and are pleased with the relevant information that we received and have incorporated some pieces into our practice.  Be assured that I will send others in the future when classes are scheduled so near to our facility.” 

“With so many rural areas closing their doors on OB services, I want to thank you for providing low cost/no cost classes and simulations for a population of patients that are being put at risk due to shortages in physicians, nurses, and healthcare costs.”  Laura Richesin, RN, Director or Women’s and Children’s Services, Starr Regional Medical Center

” We will forever be grateful for TIPQC’s training and the impact it has had on our lives! Thanks to them and the training they have offered, our EMS drivers knew how to handle our emergent situation, and therefore, helped myself and our little girl survive what otherwise would have been a tragic situation. We are so very thankful for the training and insight from TIPQC that helped our EMS drivers know exactly what to do when we needed it the most! They will never know just how much! God bless.” 

Alex, Taylor, and Elsie Mae Rose 

Annual Meeting Escape Room SIMS

The Escape Room allowed for both Infant and Maternal SIMS.  Individuals and hospital teams went through the SIMS, which included OB Emergencies, hypertension, and hemorrhage.  Infant SIMS covered topics of optimal cord clamping and severe intraventricular hemorrhage.   

“You don’t study to pass a test; you study to prepare for the day when YOU are the only thing between the patient and the grave.”  Mark Reid

Quality Improvement Bootcamp

Two QI Bootcamps were held this year under the expertise of Eva Dye, NNP, Dupree Hatch, MD, Emily Morris, MD and Christa Sala, RRT, who reminded the 52 attendees from 15 Hospitals, and 4 community agencies at the June 22 & November 7 QI Academy of Deming’s famous quote, “Every system is designed to get the results it gets.” Multiple QI strategies, tools, and games engaged and instructed participants on how to design and implement their own QI project.

Spinning Babies® Training

TIPQC was honored to host six (6) Spinning Babies® workshops in Nashville, Johnson City, Knoxville, Chattanooga, and two in Memphis with 177 attendees, 29 hospitals and 6 Doula Organizations. With one previous workshop in 2022, a total of 209 healthcare professionals were trained to better understand physiological birth and apply this knowledge, along with Spinning Babies® techniques, to help correct and prevent fetal malposition and malpresentation, and slow or stalled labor.

SYNAPSE Training

In 2023, an additional 90 SYNAPSE Training seats were secured for 9 hospitals requesting additional seats. In 2022, 130 were purchased, thus totaling 220 learning seats purchased by TIPQC. An additional 165 training seats were secured, thus totaling 385 care givers trained with over 25 online courses to improve the care of our tiniest ones!

Lactation Workforce Training

TIPQC was asked by United Healthcare and Wellpoint to support Lactation Workforce Training due to the low number of lactation professionals in the state and the new TennCare reimbursement for lactation outpatient visits.  The TIPQC Lactation Taskforce developed a three-pronged approach including:

  1. Webinar Series: 4 webinars with 147 attendees in 2023
  2. Professional Training grants which will be disseminated in 2024: International Board-Certified Lactation Consultants (IBCLC), Certified Breastfeeding Specialist (CBS), Hospital Workforce Education Training
  3. Annual meeting training & workshop

“I’m so glad I attended the webinar. I’ve been working on how to use social media to promote breastfeeding so the presentation was very helpful in my process.” -Attendee

“When I say I just shed a few tears of excitement for the CBS scholarship…I am so serious!  Thank you, thank you, thank you!”  Tanesha Carney

Healthcare Trafficking Webinar

Healthcare Trafficking Webinar was one of the most popular webinars this year with over 250 registrants!
View Webinar

Who We Serve? Families of Tennessee

TIPQC is committed to improving outcomes for the pre-pregnancy, pregnancy, and birthing population in Tennessee, through collaborative state and national partnerships.

According to the March of Dimes, Tennessee continues to have poor outcomes for our moms and babies receiving a D on the Report Card. 

  • In 2021, 1 in 9 babies (11.3% of live births) were born preterm in Tennessee.
  • The rate of preterm birth in Tennessee is highest for black infants (14.8%), followed by Whites (10.3%), Hispanics (10.1%), Asian/Pacific Islanders (9.9%) and American Indian/Alaska Natives (9.3%).
  • According to the Maternal Vulnerability Index, Birthing people in Tennessee have a very high vulnerability to poor outcomes and are most vulnerable due to mental health and substance use (The Maternity Vulnerability Index (MVI) is a tool used to understand where birthing people in each state may be more likely to have poor outcomes, including preterm birth and maternal death, due to clinical risk factors and other social, contextual, and environmental factors. Surgo Health, Maternal Vulnerability Index, 2023.)

The Tennessee Department of Health recently released the 2023 Maternal Mortality Report, 2023 Birth Defects Report, and 2023 Child Fatality Report.

Go to https://www.tn.gov/health.html

Dr. Tobi Adeyeye Amosun, Tennessee Department of Health Deputy Commissioner for Population Health states: “In 2021, 134 TN women died during pregnancy or within a year of pregnancy. Fifty-three of those deaths were pregnancy related. Almost 4 in 5 of these deaths (79%) were deemed preventable. The three leading causes of pregnancy-related deaths were COVID-19, cardiovascular disease, and substance use disorder. Maternal mortality is not distributed evenly, with non-Hispanic Black women having a pregnancy related mortality rate that is more than twice that of Non-Hispanic White women. We also see higher rates for women in West TN and for women on TennCare compared to those with private insurance. The report makes recommendations to community and statewide agencies, clinics and hospital systems, healthcare providers, and community members to promote women’s well-being, safety, and to prevent maternal deaths.”

Hospitals

Hospital Participants and partners in TIPQC projects this year:

  • Ascension St Thomas Midtown
  • Ascension St Thomas Rutherford
  • Ballad Health Bristol Regional Medical Center
  • Baptist Memorial Hospital – Union City
  • Baptist Memorial Hospital – Tipton
  • Baptist Memorial Hospital for Women
  • Blount Memorial Hospital
  • Cookeville Regional Medical Center
  • Cumberland Medical Center
  • East Tennessee Children’s Hospital
  • Erlanger East
  • Erlanger Health System
  • Fort Sanders Regional Medical Center
  • Franklin Woods Community Hospital
  • Greeneville Community Hospital
  • Hardin Medical Center
  • Indian Path Community Hospital
  • Jackson-Madison County General Hospital
  • Johnson City Medical Center
  • LeConte Medical Center
  • Maury Regional Medical Center
  • Methodist LeBonheur Germantown Hospital
  • Methodist Medical Center Oak Ridge
  • Monroe Carell Jr. Children’s Hospital at Vanderbilt
  • Morristown Hamblen Healthcare System
  • Newport Medical Center
  • Niswonger Children’s Hospital
  • Parkridge East Hospital
  • Parkwest Medical Center
  • Regional One Health
  • Riverview Regional Medical Center
  • Sumner Regional Medical Center
  • Tennova North Knoxville Medical Center
  • TriStar Centennial Medical Center
  • TriStar Horizon Medical Center
  • TriStar NorthCrest Medical Center
  • TriStar StoneCrest Medical Center
  • University of Tennessee Medical Center
  • Vanderbilt University Medical Center
  • Vanderbilt Tullahoma-Harton Hospital
  • West Tennessee Healthcare Dyersburg Hospital
  • West Tennessee Healthcare Volunteer Martin Hospital

Additional Hospitals receiving resources or education include:

  • Ascension Saint Thomas River Park   
  • Henry County Medical Center (Closed L&D Fall 2023)
  • HH Lincoln Health (formerly Medical Center) 
  • Saint Francis Hospital Memphis
  • Tennova Healthcare – Clarksville
  • TriStar Hendersonville Medical Center
  • TriStar Summit Medical Center 
  • Nashville General Hospital
  • Methodist South Hospital
  • Vanderbilt Wilson County
  • Williamson Medical Center

Patient & Family Partners

State Advisory Council:

Mary Catherine Burke, Chair

Rhonda Okoth

Bakisha Veal

Karen Broadway

Each hospital is also including patient & family partners in their project teams.  TIPQC was able to provide national training for these critical partners through MoMMA’s Voices.

“The patient family voice has been so valuable in our QI projects this year.  It has allowed the teams to truly understand and see the benefits of a collaborative effort.” -Mary Catherine Burke 

“While it is important for all families to receive high-quality, family-centered care, it is just as important for them to have a voice. Having patients and families on your team gives them the opportunity to share their experiences which helps to improve the overall culture of care, educate staff, providers, and families on evidence-based practice, and ultimately improve hospital policies and practices. TIPQC has done a remarkable job with recruiting and embedding their patient and family partners into various projects across the state to help improve outcomes for mothers and babies.” -Rhonda Okoth

Community Organizations

We partner with many dynamic local, state, and national organizations and communities to improve the pregnancy and birthing outcomes for All our Tennessee families. Thank you to our partners!

Tennessee Department of Health

National Network of Perinatal Quality Collaboratives

Health Resources and Service administration (HRSA)

Alliance for Innovation on Maternal Health (AIM)

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

Vermont Oxford Network (VON)

American College of Obstetrics & Gynecology (ACOG, District VII)

American Borad of Pediatrics Maintenace of Certification (ABP MOC)

American Aacademy of Pediatrics (AAP)

Postpartum Support Inernatinoal (PSI)

Vanderbilt University Medical Center CME

Jackson-Madison County General Hospital

Ascension St. Thomas Rutherford

UnitedHealthcare Community Plan

Spinning Babies®

Tennessee Hospital Association  

March 27-28, 2023

Annual Meeting Highlights

The Annual Meeting was amazing with relevant and meaningful speakers, workshops, SIMS Escape Rooms, and the poster session—all inspiring and re-energizing the QI work locally and across the state.  With over 420 joining in, the energy and excitement for the ongoing work as well as new projects was palpable.

View 2023 Annual Meeting

Around the state and country….

Many opportunities to celebrate the hard work going on in the state—and opportunities to share!

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Connie Graves, MD SMFM Poster Presentation on the Maternal Hypertension Project

Pediatric Academic Society Oral Presentation

Dr. Scott Guthrie presented the Optimal Cord Clamping Project at PAS 2023.

TIPQC Safe to Sleep Project and Patient & Family Engagement

Brenda Barker speaking at the Illinois Perinatal Quality Collaborative Meeting on TIPQC Safe to Sleep Project and Patient & Family engagement.

  • Institute for Health Improvement (IHI) Talk, February 8, Brenda Barker
  • Maternal Mortality Review (MMR) Talk, March 8, Dr. Danielle Tate
  • Annual Pediatric Review Conference, Amman, Jordan, March 1-3, 2023, Dr. Scott Guthrie presented TIPQC work
  • AIM National Monthly Call – Brenda Barker shared April 25, 2023.
  • Pediatric Academic Society (PAS)—Dr. Scott Guthrie attending June 15-16, 2023.
  • ABP MOC Meeting, Brenda Barker, June 15-16, 2023
  • NNPQC National Meeting Taskforce, Brenda Barker
  • Perinatal Advisory Committee (PAC) Meeting, Danielle Tate & Brenda Barker, July 13
  • NNPQC National Meeting Speaker & Poster Presentation, Dec 5-6, Brenda Barker (speaker- Infant Projects & Podcasts), Dr. Danielle Tate, Dr. Karen Schetzina, Anastacia Volz
  • PAC Meeting, Oct 19, Brenda Barker
  • Southeast Payers Symposium on Congenital Syphilis Meeting, Oct 16-17, Dr. Danielle Tate, Brenda Barker, Tara Burnett

  • State of Reform New Tennessee Healthcare Conference, Nov 8, 2023 Dr. Danielle Tate

National Network for Perinatal Quality Collaborative

National Network for Perinatal Quality Collaborative requested TIPQC talk on Utilizing Social Media and a second presentation on Infant projects, in addition to a poster session.

Publications:

Gutman CE, Scott PA, Morad A, Barker B, Scott TA. Safe to Sleep in Tennessee: A Statewide Quality Improvement Initiative. Am J Perinatol. 2023 May 11. doi: 10.1055/s-0043-1768705. Epub ahead of print. PMID: 37168012. https://pubmed.ncbi.nlm.nih.gov/37168012/

Podcasts

In 2023, we produced 50 podcasts, thus totaling 115 which are now available. Listeners increased to 7,242 a 65% relative increase in unique listeners and 9522 podcast downloads this year, with 21,176 total downloads an 82% relative increase in downloads.

Listen to Our Podcasts

This project is funded under a Grant Contract with the State of Tennessee.