2016 Agenda of Concurrent Afternoon Sessions
1:30-2:30PM Concurrent Breakouts
A) A Southwestern Indiana Collaborative to Lower Fetal Infant Mortality
Indiana’s top health care priority in 2016 is reduction in infant mortality. In 2014 Southwestern Indiana had an infant mortality rate greater than 10 deaths for every 1,000 births. To overcome these staggering rates, Southwestern Indiana has joined forces to strengthen the Fetal Infant Mortality Review (FIMR) process and developed a collaborative initiative called Healthy Baby Steps. Join us as we discuss our journey to improving southwestern Indiana’s infant mortality rate.
Lynn A. Herr, RN, BSN, CPN, Vanderburgh County FIMR Coordinator
Jeri Kenning, RN, BSN, Supervisor PHN/Outreach, Vanderburgh County Health Department
John E. Girton, Jr.
Kyle Pruett, MD
C) Better Data, Better Outcomes: Vital Records Data Quality Initiatives
Birth and death data are obtained by the Indiana State Department of Health’s (ISDH) Division of Vital Records (Vital Records) from the submission of information for birth and death certificates. This data is used throughout ISDH, as well as myriad external agencies, researchers, and data requestors.
Vital Records has initiated multiple projects focused on improving the quality of reported birth and death data. There are currently three large projects underway:
1) hospital birth data quality improvement initiative,
2) death data quality and timeliness improvement project, and
3) development of a new, comprehensive Electronic Vital Events Registration System (EVERS).
Anne Reynolds, MPH, Vital Records Epidemiologist, Indiana State Department of Health
Rachel Foster, MPH, Data Analyst & EVERS Coordinator, Division of Vital Records, Indiana State Department of Health
D) Understanding Adverse Childhood Experiences (ACEs) and the Impact on Health Outcomes: A New Approach to Population Health
The ACE study authored in the mid-1990’s houses a wealth of information on adverse childhood experiences and how their effects are interrelated, endemic, and transcend the traditional boundaries of health and human service systems. Understanding aces and their effects and concepts can provide for unifying framework for multi-sector action and the principals and practical skills of trauma-informed care can be applied directly to community building processes, adult lives, and daily decision making. Important to note- aces are intergenerational; laying the foundations for some that keep the negative experiences happening. ACEs have been linked to health outcomes such as infant mortality, obesity, liver disease, and mental health issues.
Preventing ACEs will prevent homelessness, unemployment, incarceration, disability, learning problems, and poverty. If we can switch our approach to public health changes and look at it collectively with a trauma-informed lens, we can break down the social issues that stand in the way of achieving positive health outcomes.
Robin Vida, MPH, CHES, Director of Health Education, St. Joseph County Health Department
E) Tobacco – Promoting Healthy, Smoke Free Homes
Creating smoke free homes is critical to a healthy start in life. This session will discuss what is known about the harms of secondhand smoke and third hand smoke and its effect on youth children and pregnant women. The session will provide the steps to helping a property go smoke free. Available resources will be reviewed to provide home health workers and providers that serve young families information that they can share with the families they serve.
Cathy Blume, American Lung Association, Manager, Tobacco Control
Patricia Tyrus, Department of Housing and Urban Development
F) Ready, Set, Go: Parental Readiness for Infant Safe Sleep
The purpose of this Doctor of Nursing Practice scholarly project is to identify factors that affect parental readiness to execute safe sleep behaviors in conjunction with the implementation of a standardized infant safe sleep toolkit. The study was conducted in a large urban mother-baby unit and utilizes The Theory of Planned Behavior as a conceptual framework. A comprehensive literature review of safe sleep environmental risks and evaluation of Australian maternal-child services impacting infant mortality rates will also be included in the presentation content.
Kim Hodges MSN, RN, NE-BC, Doctor of Nursing Practice Student and Manager of Clinical Operations Pediatric Intensive Care Unit, Purdue University School of Nursing West Lafayette and Riley Hospital for Children at Indiana University Health
G) Bridging the Accessibility Gap, Together
The partnership between Nurse-Family Partnership (NFP) and Eskenazi Health (EH) will be presented as a model for partner collaboration in NFP’s statewide expansion. The partnership focuses on supporting both organizations in order to effectively improve maternal child health in Indiana. By the end of the session attendees will understand how a mutually beneficial partnership can improve access to services and enhance utilization, in order to reduce infant mortality. Attendees will also learn additional considerations for effective partnerships in rural communities.
Lisa Crane, MSN, RN, Senior Director, Nurse-Family Partnership of Goodwill Industries of Central Indiana
Joel D. Gomez Bossio, MAHS, Team Lead of Prenatal Population Health & Community Services, Eskenazi Health Center
Ashley Wilson, RN, BSN, Nurse Home Visitor, Nurse-Family Partnership of Goodwill Industries of Central Indiana
H) Practical Pearls for Partnering in Transport
The unique environment for maternal and neonatal transport lends itself to the collaboration of many people for its success. With the enhancement of the transport services at The Women’s Hospital in Newburgh, Indiana, we quickly figured out that drawing upon the expertise of many experts would help to ensure our success with the program.
When educating our transport staff, we have also partnered with others for this education. Partnering with our medical directors for education that both they feel is important to staff as well as requests from staff for certain topics from them. Debriefing runs is one of the best education tools that we can use for transport staff and when the team medical directors are present and partnering with us in debriefing, both nursing and medicine can come together with their thought processes related to each specific run.
Finally, we will end with the partnerships we have developed with each other within the transport services teams. We will speak about partnerships within the maternal and neonatal teams as well as partnerships developed as transport services staff at The Women’s Hospital.
Beth Durham, MSN, RNC-NIC, C-NPT, NICU Educator/ Transport Coordinator at Deaconess Women’s Hospital
Lori Grimm, RN, MSN, CPHQ, Quality and Patient Safety Officer
Jessica Bernhardt, MSN, RNC-OB, OB Educator/Transport Coordinator at Deaconess Women’s Hospital
I) Building the Framework
Over the last five years, the ISDH has prioritized efforts to improve outcomes for mothers and babies by reducing perinatal mortality and morbidity rates in Indiana. In partnership with health care professionals, hospitals and related organizations, the framework of a high quality perinatal health care system has been designed to ensure that all pregnant women deliver in a risk appropriate environment that supports optimal outcomes for both the mother and the newborn. The three components of the framework are: Levels of Care Standards for Obstetric and Neonatal hospital units; Inter-facility Transfer Programs; and Perinatal Centers of Excellence. In developing the framework components, The ISDH made the commitment to meet but not exceed national standards established by the American Academy of Pediatrics (AAP), the American College of Obstetrics and Gynecology (ACOG) and other related organizations. Through the Indiana Perinatal Quality Improvement Collaborative (IPQIC), over 200 health care professionals, hospitals and associated organizations have partnered with ISDH to bring their knowledge and expertise to support this effort.
This session will provide the rationale for development of this framework, the detail for each component, challenges and opportunities for enhancing the perinatal system and the timeline for final implementation.
Maureen Greer, Emerald Consulting/IPQIC
Art Logsdon, JD, ISDH Assistant Commissioner
Martha Allen, MCH Director
3-4PM Concurrent Breakouts
[Description to come]
Chris Belcher, MD
B) Partnering through Dollars and Sense
Participants will see how creative grant-making has been used to build a community network of resources and partnerships to address infant morbidity and mortality in vulnerable populations;
Participants will hear why community agencies, frequently overlooked, are important to address the multi-factorial causes of infant mortality;
Participants will hear about ideas to improve the effectiveness of community wide partnerships through education networks, creation of a medical decision tree and referrals in the future;
All Participants will receive a copy of the published46 page “2016-17 Pregnancy Resource Directory” listing 31 Allen County Indiana community partners committed to fighting infant mortality and how and when to access them by stage in the pregnancy or by name and types of services.
Meg Distler, Executive Director, St. Joseph Community Health Foundation
C) The 5 W’s of Milk Banking
Human milk is the perfect food for all infants, including premature and ill infants, and should be provided exclusively for the first six months of life (Academy of Breastfeeding Medicine Board of Directors, 2008; American Academy of Pediatrics, 2005, 2012). When mother’s own milk is not available, pasteurized donor human milk (PDHM) is an ideal alternative (American Academy of Pediatrics, 2005, 2012; United States Breastfeeding Committee, 2008). As the knowledge regarding the safety and efficacy of PDHM increases, so does the demand. But human milk is a scare resource, with a limited supply being available. Unfortunately, many breastfeeding women are unaware of the need for their excess breastmilk, and many health care providers are unacquainted with the process of acquiring PDHM from a nonprofit milk bank for use with NICU infants. This session will provide an overview of human milk banking including who donates; how the donors are recruited and the donor milk is collected by the milk bank; the pasteurization process; where PDHM is available; and how hospitals and others that need the PDHM can receive it. This session will also discuss the safety of PDHM and the guidelines provided by the Human Milk Banking Association of North America, the organization that provides oversight to the nonprofit human milk banks in the United States. Some history of The Milk Bank will be relayed along with how health professionals can help find human milk donors and promote the use of PDHM.
Janice Sneider O’Rourke, MPA, RD
D) Pamper Your Partners-even if they are the Judge!
•Learn how to create a community based system of care to reduce infant mortality by partnering with unsuspecting partners such as juvenile probation and the court system; a teen pregnancy prevention program; and of course, the usual partners across the community.
•Learn what strategies should be included in your system for the best outcomes in lowering infant mortality rates.
•Learn how to make every partner a winner.
Carol Price, Director Healthy Communities of Clinton County Coalition (HCCCC)
Kathy Martin, Coordinator Baby & Me Tobacco Free at HCCCC
Libbi Smith, Prenatal and Early Start Coordinator at HCCCC
Ryan Adcock, Director Cradle Cincinnati
E) Prenatal Nutrition Impacting Fetal Infant Mortality: A Public Health and Educational Perspective
Adequate nutrition plays a significant role in prenatal care of the mother and her developing fetus. Together, nutrition and education have been shown to lower the risk of preterm births, low birth weights and infant mortality. The USDA and CDC support nutritional efforts of public health programs that promote healthy lifestyle choices. The Vanderburgh County WIC Program plays a role in combating fetal infant mortality in our region.
Mary Ellen Stonestreet RD CD WIC, Vanderburgh Co Health Department
Brooke Sacksteder RD, CD WIC, Vanderburgh Co Health Department
LaRissa Madison RN, IBCLC WIC, Vanderburgh Co Health Department
E) It’s not just about crying
The rate of gestational hypertension and gestational diabetes is 6-8%. The rate of pregnant and postpartum women who will develop a Perinatal Mood or Anxiety Disorder is 21%. The consequences of not recognizing or treating a Perinatal Mood Anxiety Disorder can be devastating–for mom, baby, and family. This workshop will discuss recognizing a PMAD, the consequences of an untreated PMAD, and resources and treatment options available.
Birdie Gunyon Meyer, RN, MA, Coordinator, Perinatal Mood and Anxiety Disorders Program, Indiana University Health
F) Fetal Demise Assessment: A Way To Understand Infant Mortality
The top three causes of infant deaths among all races and among whites are disorders related to short gestation-low birth weight, congenital anomalies and Sudden Infant Death Syndrome. Attempting to determine the cause of fetal death remains important because it may influence estimates of recurrence and future pre-conceptional counseling, pregnancy management, prenatal diagnostic procedures, and neonatal management.
We present data from our experience during the past three years of the Fetal Demise state wide program in our institution. We briefly review diagnoses seen, particularly those of placental insufficiency in which a vascular cause of demise was suspected. The information provided by fetal demise programs helps the understanding of the subsequent causes of infant mortality such as short gestation and birth defects which constitute the top two causes of infant mortality. We review the value of appropriate management of fetal tissue by pathology and dysmorphology as well as the value of photographic evaluation post mortem when conceptional products are not available. The value of postmortem evaluation in fetal demise and patients lost before one year of age is essential to understand and decrease infant mortality in general.
Luis F. Escobar, MD. Medical Director of Medical Genetics and Neurodevelopmental Center, St. Vincent Hospital.
G) Perinatal Patient Safety—“What we have here is a failure to recognize and communicate”
This presentation will focus on issues that contribute to failure to recognize fetal status changes, well-intentioned but ineffective communication, human factors and adverse events. Strategies to reduce preventable harm, improve intrapartum recognition of fetal status change, optimize both the content and the delivery of the fetal status changes will be presented.
Elizabeth McIntire, MSN, RN WHNP-C, C-EFM, Director Riley Maternity and Newborn IU Health Riley
H) Perinatal Substance Use in Indiana: What We Have Learned
The Indiana Perinatal Quality Improvement Collaborative (IPQIC) has developed protocols and materials that are designed to address the growing population of newborns who have been exposed to legal and illicit substances in utero. Through the efforts of the Perinatal Substance Use Committee, four Indiana hospitals have been participating in a six month pilot process with the purpose of testing both the protocol and materials and beginning the process of identifying the true prevalence of substance exposed infants. This session will discuss the process used, preliminary findings and potential next steps.
Maureen Greer, Indiana Perinatal Quality Improvement Collaborative, IDEA ITCA, Emerald Consulting
Cancellation Policy: Refunds are not available for any cancelled registration. You may substitute a colleague to attend in your place. This must be submitted in writing at least 14 days prior to the Summit. Substitutions will not be accepted after 14 days. Mahern Events, Inc., 940 East Garfield Drive, Indianapolis, Indiana 46203, USA, 317-313-4046. OR, email at [email protected]
Accreditation Statement: The Indiana Department of Health is accredited by the Indiana State Medical Association (ISMA) to provide continuing medical education for physicians.
Designation Statement: The Indiana Department of Health designates this live activity for a maximum of 4.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.