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MDHHS launched the Michigan Perinatal Quality Collaborative (MI PQC) in 2015; over the past several years, all 50 states along with the District of Columbia have established State Perinatal Quality Collaboratives. The State Perinatal Quality Collaboratives, including the MI PQC, are part of the National Network of Perinatal Quality Collaboratives (NNPQC).
Contact Michigan's Perinatal Quality Collaborative Coordinator to learn more.
Recognizing the diverse geographic and demographic nature of the state, Michigan approached its structure of the PQC in a unique manner. The Michigan PQC (MI PQC) is comprised of nine (9) Regional Perinatal Quality Collaboratives (RPQC), representing the state’s ten (10) Prosperity Regions (see map above), with all nine established by 2019.
As an individual’s health outcomes are attributed to clinical care, as well as environment, socioeconomic factors, and health-related behaviors, the RPQCs utilize both community and clinical approaches by bringing together health care professionals, community partners, families, faith-based organizations, Great Start Collaboratives, home visiting agencies, and others in a unified, collaborative effort.
RPQC Approach:
Advancing Equity
♦ Actively addressing health inequities, social determinants of health and disparate outcomes.
♦ Partnering with Maternal Child Health Epidemiology to collect, analyze, and share data for equitable outcomes.
Implementing and expanding care for families affected by Perinatal Substance Use Disorder (PSUD)
♦ Increased screening for mental and behavioral health concerns at prenatal and family planning clinics through utilization of an electronic screening tool (such as High Touch, High Tech).
♦ Increased accessibility of Medication-Assisted Treatment (MAT) for pregnant & postpartum people, as well as coordination of prenatal care for pregnant people receiving MAT.
♦ Establish rooming-in policies and procedures for families with babies born substance-exposed at participating birthing hospitals.
Expanding and improving access to respectful, quality care throughout the pregnancy and postpartum period
♦ Promoting and expanding CenteringPregnancy© as an evidence-based model of prenatal care.
♦ Increased referrals and enrollment to evidence-based home visiting programs through various interventions, including enhanced social media posts, warm hand-offs from trusted providers, referral hubs, etc.
♦ Bolstering virtual birthing and breastfeeding education and support.
♦ Building a diverse doula workforce through training, mentorship and continued education opportunities.
Download the Michigan Perinatal Quality Collaborative Information Sheet to learn more about improving birth outcomes for Michigan families.
Region 1 Perinatal Quality Collaborative was initiated in 2017 with a goal of ensuring mothers and babies are healthy and thriving across the Upper Peninsula. The predominantly rural Region covers 15-counties and is home to an extensive coastline on the Great Lakes, large tracts of state and national forests, about 4,300 inland lakes, and more than 150 waterfalls.
Geographic location - Upper Peninsula
Neonatal Abstinence Syndrome (NAS) and maternal opioid use continue to be key priority areas for the region, as the Upper Peninsula has the highest rate of NAS in Michigan.
Region 1 built upon the planning and development that took place during the previous project periods and took action on the gaps that emerged as a result of their needs assessment. The region will continue the following activities and anticipated measurable outcomes which align with Michigan’s goal of building a locally linked, coordinated network to support the highest standard of health for mothers and their babies in Michigan:
♦ Coordinate and provide resources for workforce development opportunities related to NAS and perinatal care
♦ Promote and expand the use of Long-Acting Reversible Contraceptives (LARCs)
♦ Implement and expand Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT)
♦ Convene a workgroup to improve coordination across care systems
♦ Minimize barriers for pregnant people with SUD by way of integrated care teams
♦ Implement High Touch, High Tech (HT2) electronic screening, brief intervention, and referral for treatment program (eSBIRT)
Upper Peninsula (UP) Maternal Opioid Misuse (MOM) Model: UPHCS recently received a grant award from the Health Resources and Services Administration to address maternal opioid misuse use region-wide. The goal of the program is to improve the quality of care for pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD) by implementing community health worker (CHW) centered care coordination strategies that focus on cross-system collaboration and improved health outcomes.
Website - https://www.uphcs.org/rpqc/
Regions 2&3 Perinatal Quality Collaborative was the initial RPQC and was formed in 2011. Funding was initiated in 2015. The primarily rural region covers 21-counties near the northern shores of Lake Michigan and Lake Huron. Bordered by two of the Great Lakes, the Northern Lower Peninsula has glorious scenery everywhere you look, seemingly endless miles of outdoor adventures and some of the most picturesque spots in all of Michigan.
Geographic Location - Northern Lower Michigan
Perinatal Substance Use Disorder (PSUD) and Medication Assisted Treatment (MAT):
Healthy Futures - Universal Home Visiting:
Birth Equity:
Region 4 Perinatal Quality Collaborative was initiated in 2016. Most of the Region is along the Lake Michigan shoreline with miles and miles of soft-sand beaches and quiet rural towns. The Region is also home to destination urban cities full of unique Michigan attractions, adventure and entertainment.
Geographic location – West Michigan
Region 4 has developed two workgroups to address infant mortality and morbidity. The first group is addressing the need to identify and refer women with active or at risk for substance use disorder (SUD). The second group is focused on increasing use of already existing evidence-based perinatal home visiting programs.
Home Visiting Workgroup
This workgroup has explored social media’s influence on home visiting engagement in the region. Their first efforts in this area were to investigate how creating a consistent social media campaign for Help Me Grow Ottawa impacted home visiting referrals and enrollments. Then, measuring how paid boosting social media posts increased engagement in MIHP using Strong Fathers/Padres Fuertes - Strong Beginnings. Now, the workgroup is piloting a testimonial video of families who have experiences with home visiting on Kent County Great Start Collaborative’s social media outlets to increase awareness and trust in home visiting programs in the region.
Substance Use Workgroup
The substance use workgroup is working in collaboration with the team from mirecovery.org. The website provides a comprehensive set of options for recovery from substance use disorder and addiction. Region 4 has worked to add a new section that focuses on pregnant people and new mothers. The substance use workgroup is working to promote the website to increase use of this resource.
Region 5 Perinatal Quality Collaborative was initiated in 2018. The Region is home to the beautiful Saginaw Bay of Lake Huron, one of the largest coastal wetlands on the Great Lakes. The watershed has canopies of sheltering hardwoods on the edge of the marsh, miles of outdoor recreation trails, and parks. Along with outdoor adventure and calm rural scenery, the Region also has several small urban cities with their own unique attractions, and adventures.
Geographic location – Saginaw Bay Area
Region 5 has worked to expand Centering Pregnancy (a group prenatal care model) across the region and include curriculum focused on Perinatal Substance Use Disorder (PSUD).
The collaborative has provided trainings to providers and stakeholders on reducing stigma for perinatal substance use and SCRIPT (smoke cessation and reduction in pregnancy treatment)
In collaboration with Saginaw County Community Mental Health Authority, Region 5 has offeredonline behavioral health services and resources through aMyStrength subscription, open to the public.
Region 6 Perinatal Quality Collaborative was initiated in 2019. The thumb area is surrounded by the rolling sand dunes and sparkling blue waters of Lake Huron. The Region is full of rural countryside, beach-side beauty and small town charm. Region 6 is also home to Flint, Michigan a vibrant city full of exciting attractions, art, museums and outdoor adventure.
Geographic Location - Thumb Area
Region 6 prioritizes engaging community members in the collaborative. The leadership values the experiences and expectations that caregivers bring to collaborative meetings. One approach the region has taken is reaching out to community members who are vested in maternal child health outcomes and asking them to bring their experience and knowledge to the collaborative. Region 6 has great community representation and has received positive feedback.
Region 6 continues to partner with Dr. Steve Ondersma and his team on the High Touch High Tech (HT2) project. HT2 provides universal perinatal screening to identify SUD, mental health and trauma concerns in pregnant people during prenatal care visits. The HT2 app screens for major behavioral risks such as substance use and depression, helps build motivation to make changes, and facilitates connection with available services.
Website: https://www.region6pqc.org/
Region 7 Perinatal Quality Collaborative was initiated in 2019 with a goal of ensuring mothers and babies are healthy and thriving across Clinton, Eaton and Ingham Counties. The Region consists of both urban and suburban areas, along with gently rolling hills, beautiful rural farmland, and unique small towns. Region 7 is home to Michigan State University, and is the site of the Michigan State Capitol, the State Supreme Court, the Court of Appeals, a Federal Court, the Library of Michigan, Michigan's History Center and an array of outdoor nature parks, dining options and more.
Geographic location –
Region 7 has launched their CenteringPregnancy project at Cedar Women’s Health Clinic within the Ingham County Health Department.
The region has worked diligently to increase opportunities for training, education and outreach related to health equity and maternal and infant health. This includes film screenings of the movie Toxic and WKAR's NOVA film, Twice as Likely. These opportunities highlight disparities in maternal and infant mortality and morbidity.
Region 7 conducted virtual parent support groups for pregnant women and new mothers throughout the pandemic. The content of the support groups covered wholistic wellness, pandemic specific concerns, guided meditation, seven tips for self care, signs of anxiety and depression, and mindfulness. A session specifically for women of color was offered, and this session had the highest attendance.
The region developed a vaccine uptake media campaign called “This is Your Shot.” The campaign materials appeared on social media, digital ads, billboards, CATA buses, and broadcast TV, reaching an estimated 1.4 million views combined. The region is planning and organizing vaccine education courses for perinatal individuals.
In September 2022, Region 7 held a retreat with collaborative members to foster greater connection and identify future activities for the region. As a result of that meeting, three subcommittees were formed to advance the goals of Region 7: Uplifting Community Voice, Using Data to Examine and Address Disparities, and Researching Promising Practices.
The Region is known for its quaint beach towns and miles of sandy beaches, the opportunities to enjoy the best of the Lake Michigan shoreline are endless. Consisting of both suburban areas and beautiful rural farmland southwest Michigan is known for its small-town charm. The largest city in the region is Kalamazoo, with a population of 80,000. The city is home to Western Michigan University as well as Kalamazoo College. It boasts a diverse population that generates a metropolitan feel in a smaller scale city and is known for its four-season outdoor recreational activities.
Geographic location – Region 8 (Berrien, Branch, Calhoun, Cass, Kalamazoo, St. Joseph, and Van Buren)
Vision: Women and infants throughout Southwest Michigan will have access to quality, coordinated health services regardless of their race or income.
Mission: Facilitate authentic collective impact and community focused strategy by connecting families and partners in Southwest Michigan to drive systems change in maternal and infant health.
In 2023, SWMPQIC received additional funding from the Blue Cross Blue Shield Foundation Advancing Maternal Health Equity Grant to provide Perinatal Mood and Anxiety Disorder: Components of Care training to at least 100 health care professionals in the region. The grant is also allowing SWMPQIC to host a monthly Perinatal Mood and Anxiety Disorders: Reducing Your Risk class to pregnant persons to help prepare one’s mental health for birth and baby.
Website – www.SWMPQIC.com | Facebook | Instagram
Region 9 Perinatal Quality Collaborative was initiated in 2019 working to ensure healthy moms, and healthy babies. Region 9 aims to develop data-driven, innovative strategies that are tailored to the strengths and challenges of the region to address preterm birth, very low birth weight and low birth weight, as well as maternal and infant mortality. The Region is home to Ann Arbor, a college town wrapped tightly around the University of Michigan. The city and it's nearby neighbors are well-known for globally-inspired cultural offerings, renowned galleries, museums and arts. The area is home to unique small businesses and family owned dining options. The Region covers 6 counties and consists of Metropolitan cities which are mixed urban-suburban areas, along with beautiful rural farmland, and unique small towns.
Geographic location – Region 9 (Hillsdale, Jackson, Lenawee, Livingston, Monroe, Washtenaw)
Leadership Team and Structure:
Fiduciary Organization: Michigan Medicine Department of Obstetrics and Gynecology
The Mom+ Centric workgroup received funding from the Michigan Health Endowment Fund to support the diversification of the Doula workforce in Southeast Michigan. This project includes three components: 1) Education for both community members and care providers, 2) Financial sponsorship of a diverse cohort to become trained as Doulas, and 3) Developed mentorship program to connect newly trained Doulas with established Community-Based Doulas. The DONA Doula training took place in early March 2023 and 27 individuals from across Region 9 participated. Each member of the cohort is connected with one of eleven mentor doulas to help with the transition from training to connecting with clients.
The Trauma-Informed Care workgroup piloted four trauma-informed toolkits with the Corner Health Center during the Summer of 2022 and saw an increase in positive patient experience. After community review of the toolkits, one participant shared, “This is going to be really helpful. It’s sad that we aren’t there yet, but this makes me hopeful to see where care will go.” Next phase is to trial the toolkits in another site to assure that it will address the wider needs of our collaborative clinic populations. The workgroup looks forward to supporting other Region 9 clinics with toolkit implementation. Additionally, the workgroup received funding from the Michigan Maternal Mortality Surveillance Program to develop trauma-informed trainings. These trainings will be ready for statewide rollout in the fall of 2023.
The Home Visiting workgroup is working to support all home visitors in Region 9 through education, collaboration, and communication. We plan to convene with home visiting professional across the different counties and program models to strengthen partnerships and learn together.
The Region 9 PQC challenges you to develop a deeper understanding of how racism and inequity impact perinatal health by subscribing to the Health Equity Communication Challenge! Registration is now open for version two of the challenge. During 2022, we more than doubled the number of subscribers and are confident that we will double it again! Register at region9.org/health-equity and receive weekly emails in December 2022, March 2023, June 2023, and July 2023.
Email – contact@region9.org
Website – www.Region9.org
Social Media – Instagram: @region9mi, Facebook: Facebook.com/Region9MI
Region 10 Perinatal Quality Collaborative was initiated in 2015. The goal of SEMPQIC is to provide leadership, coordination, and opportunities to eliminate the root causes of perinatal inequities through collective impact and system reform so that all birthing people and babies in Region 10 have optimal health outcomes.
Geographic location - Region 10 (Wayne, Oakland, and Macomb)
Healthy Baby at Home
SEMPQIC works with Maternal Infant Health Program (MIHPs), and other evidence based home visiting programs, prenatal clinics, and hospitals to implement the Healthy Baby at Home (HB@H) initiative to increase utilization of evidence-based home visiting programs. The initiative has successfully created a model for referral protocols to home visiting services for prenatal clinics and hospital NICUs.
Needs Assessment Survey
In its early implementation, SEMPQIC surveyed organizations about work on the six priorities in the Mother Infant Health & Equity Improvement Plan (MIHEIP) to identify service gaps and strategies to achieve the MIHEIP goals. Survey results are used to create a document to track progress for implemented strategies in Region 10. The leadership team works with coalition members to determine how to address service gaps and create an action plan to move forward.
Respondents reported highest implementation of these MIHEIP recommendations: ensure women are connected to early comprehensive prenatal care and home visiting programs and educating women and families on the connection between tobacco use and unhealthy babies. Strategies implemented the least: assessing and improving how non-traditional institutions (i.e., housing, environment, education) utilize a health and equity lens in policies and procedures and ensuring that teen pregnancy prevention programs exist in schools and communities.
COVID-19
The pandemic disproportionately affected African Americans in Region 10, due to being overly represented in the essential workforce (e.g., grocery store workers, food service workers, etc.) and other social determinants of health. SEMPQIC met virtually to discuss the pandemic related to pregnant and postpartum women and how to address barriers to proper care. The conversations resulted in several recommendations which were shared with the State Coronavirus Task Force on Health Disparities. The coalition will continue to discuss the pandemic relative to pregnant and postpartum women, how the recommendations have been used and how SEMPQIC can continue to support the work of the Task Force. Videos with community voices were created for public use to encourage COVID-19 vaccination uptake in Region 10. View the “Trust Me… I Care” campaign: https://www.youtube.com/@sempqic
Additional Initiatives
Foundational investment in SEMPQIC by W.K. Kellogg Foundation supported the creation of the Detroit Health Equity Education Resource. This website offers a variety of resources related to health equity including an Equity Data Dashboard. Explore the website to learn more: www.detroithealthequityresource.org.
Merck Safer Childbirth Cities provided 3 year funding for Cohort 2 participation to reduce maternal mortality in Detroit. See the SEMPQIC website at www.sempqic.org for more details of Project Detroit: Voices for Life, a project including four community based partners addressing perinatal health improvement in the Detroit metro area.
Other initiatives led by SEMPQIC include work with MI-AIM, a Fatherhood Project, and a Blue Cross Blue Shield of Michigan Foundation investment to examine available services for post-partum depression.
Email: info@sempqic.org
Website: https:///www.sempqic.org
Facebook: Southeast Michigan Perinatal Quality Improvement Coalition
LinkedIn: https://www.linkedin.com/company/sempqic/
For more information on the RPQC's,
please contact:
Emily Goerge, MPH, MSN, RN
Perinatal Nurse Coordinator
GoergeE@Michigan.gov