Alliance for Innovation on Maternal Health Care for Pregnant and Postpartum People with Substance Use Disorder Quality Improvement Project (AIM SUD QIP)

The Alliance for Innovation on Maternal Health Care for Pregnant and Postpartum People Substance Use Disorder Quality Improvement Project (AIM SUD QIP) is a quality improvement project that falls under the larger Maternal Safety Quality Improvement initiative sponsored by the Ohio Department of Children and Youth.

In recent years, overdose was the leading cause of pregnancy-related deaths overall, with 91% of pregnancy-related overdose deaths deemed preventable. To reduce the rate of preventable deaths attributed to SUD in Ohio, targeted interventions at the provider, hospital, and system levels are required. The AIM SUD QIP is administered by the Ohio Colleges of Medicine Government Resource Center (GRC), and in partnership with The Ohio State University’s Wexner Medical Center, MetroHealth, the Cleveland Clinic Foundation, and the Ohio Hospital Association.

The AIM SUD QIP seeks to address severe maternal morbidity and mortality by implementing best clinical practices and quality improvement tools to improve the identification, treatment, and care for birthing persons, as well as decrease bias and stigma in the prenatal and postpartum period for individuals experiencing SUD. In addition, through collaboration with clinical leaders and state partners, the project aims to prioritize a focus on health equity in order to achieve the goal of reducing disparities. Ohio will utilize the AIM Care for Pregnant and Postpartum People with Substance Use Disorder Change Package, along with supplemental materials created to address Ohio’s unique landscape. The change package incorporates evidence-based interventions centering on the “5 R” domains established in the AIM patient safety bundles, including Readiness, Recognition, Response, Reporting, and Respectful and Equitable Care.

With the support of quality improvement coaches, participating sites will test strategies and interventions to implement best clinical practices, including but not limited to implementing validated screening tools, addressing treatment needs including medication for opioid use disorder (MOUD), and building collaboration and linkage to community supports and resources.

Participating sites will submit data via a customized collection form will be submitted and analyzed on a monthly basis to track project progress and provide a feedback mechanism for each team to evaluate the performance of PDSA testing cycles. Additional data will be collected quarterly on-site capacity and standardized protocols.

In Phase 1, the AIM SUD QIP will engage 23 labor and delivery hospitals in QI implementation starting January 2025. Additional hospitals will be engaged starting January 2026 and leverage lessons learned during the pilot phase to provide effective and quality care to birthing persons experiencing SUD.