Ohio Alliance on Innovation in Maternal Health Care for Pregnant and Postpartum Women with Substance Use Disorder (AIM SUD)

In recent years, overdose has been 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 Alliance for Innovation on Maternal Health Care for Pregnant and Postpartum People Substance Use Disorder (AIM SUD) Quality Improvement Project 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. Through collaboration with clinical leaders and state partners, the project aims to prioritize health care best practices to ensure every patient receives the highest quality care. 

Ohio utilizes 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 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 submit data via a customized collection form, which is then collated and analyzed monthly to track project progress and provide a feedback mechanism for each team to evaluate the performance of PDSA testing cycles. 

In Wave 1, the AIM SUD QIP project engaged 24 birthing hospitals that began QI implementation in January 2025. Additional hospitals will be engaged starting in January 2026 and leverage lessons learned during the pilot phase to provide effective and quality care to birthing persons experiencing SUD. 

The AIM SUD Quality Improvement Project falls under the wider Maternal Safety Quality Improvement initiative sponsored by the Ohio Department of Children and Youth. It is administered by the Ohio Colleges of Medicine Government Resource Center (GRC) in partnership with The Ohio State University’s Wexner Medical Center, MetroHealth, the Cleveland Clinic Foundation, and the Ohio Hospital Association.