Ann Elrington, MD, PhD was most recently Chief Medical Officer and Senior Vice President, Detroit Community Health Connection in Detroit, MI. She practices obstetrics and gynecology at her health center and is an attending physician at the Detroit Medical Center. Dr. Elrington has presented before the Secretary's Advisory Committee on Infant Mortality (HRSA) and continues her work to achieve equity in birth outcomes and the health and wellness of African American women in Detroit, Michigan. She is most interested in defining, developing and implementing public health policies and strategies towards these efforts. Dr. Elrington consults in Maternal and Child Health for the Pan American Health Organization. She is the past Dean of Academic Affairs, University College of Belize (1990-1992) and lecturer/coordinator in applied sciences at the Belize College of Arts, Science & Technology (1982-1985). As a Fulbright scholar, Dr. Elrington pursued a Ph.D. in Organic Chemistry from Emory University, Atlanta, GA (1990). She received her medical degree from Wayne State University School of Medicine, Detroit, MI (1998), and participated in Harvard's Medical School Visiting Clerkship Program (1997). Dr. Elrington completed her residency in obstetrics and gynecology at Hutzel Women's Hospital, Wayne State University/Detroit Medical Center in Detroit Michigan (2002).
Ann Gillett-Elrington, MD, PhD, MPH
Associate Professor, Ross University School of Medicine, Bridgetown, Barbados
Building Capacity for Impact: The Massachusetts Perinatal Quality Collaborative and Prematurity Prevention
Background:
State Perinatal Quality Collaboratives have great potential to positively affect birth outcomes. As this pertains to health equity and health policy, these organizations have been successful in creating functional collaboration among participating clinical sites in using improvement science to achieve feasible, measurable outcomes that improve health. The Massachusetts Perinatal Quality Collaborative (MPQC) has shared in similar success with collaborative programming among 47 participating maternity centers to reduce the rate of early elective deliveries. The present work examines the issue of preterm birth in the Commonwealth, as a charge of the MPQC Prematurity Prevention Committee. While the overall preterm birth for Massachusetts has decreased to 8.6% in 2012, the rate for black mothers is disproportionately higher at 10.1%. This project seeks to identify feasible and measurable quality improvement programs for this MPQC committee to implement to reduce premature deliveries and the preterm birth disparity.
Methods:
Review of the literature and interviews with researchers and policy experts were conducted to identify intervention programs to reduce the preterm birth disparity gap between black and white mothers in Massachusetts. A survey of the MPQC prematurity prevention committee members was undertaken to clarify perceived and operational priorities and roles in quality improvement to reduce preterm birth.
Results:
The proposed intervention creates an aligned vision for quality improvement based on the Institute for Health Care Improvement (IHI) Breakthrough Series and other improvement science. The development of driver diagrams and logic models addressing some of the causes of preterm birth and implementation pathways will allow this MPQC committee to establish statewide priorities and protocols for prematurity prevention, as well as foster improved health outcomes for reproductive aged women over the lifecourse. The ability of these interventions to reduce the disparity in preterm births that exists for black mothers will be assessed.
Future
Discussion:
Preterm birth is the most significant unsolved problem in perinatal medicine and the leading cause of neonatal, infant and under 5 morbidity and mortality. The burden of preterm birth is a great public health issue affecting cost and quality of life. Comprehensive health-system and community-based interventions are necessary to support the health of reproductive age women, reduce psychosocial stress, and enhance community assets. This MPQC intervention seeks to address factors associated with the disparity in preterm birth rate through quality improvement science, policy development and effective translation.
Preceptor:
Audra Meadows, MD, MPH
Brigham & Women’s Hospital: Obstetrics & Gynecology
Medical Director, Boston Healthy Start Initiative, Boston Public Health Commission
Chair, Prematurity Prevention Sub-Committee, Massachusetts Perinatal Quality Collaborative
