The funding — administered on behalf of the Centers for Medicare & Medicaid Services — supports a new partnership between MDA and the Missouri Department of Health and Senior Services' Office on Women's Health, aimed at expanding the rural maternal health workforce.

For hospital and health system leaders, this initiative addresses rural maternal health workforce shortages. MDA will build recruitment pipelines, formal credentialing systems, and integration pathways for community-based doulas and perinatal community health workers, who provide support throughout pregnancy, childbirth and postpartum recovery.

As these professionals become integrated into rural health care teams, hospitals may see expanded care team capacity, new opportunities to partner with a growing credentialed workforce and stronger community ties around maternal health service lines.

About the Rural Health Transformation Program

The Rural Health Transformation Program, created under the One Big Beautiful Bill Act (OBBBA), is a landmark federal initiative to strengthen rural Americans' health care access and outcomes through sustainability and innovation. Beginning in 2026, the program provides $50 billion over five years, divided equally between state-distributed funds and competitive grants to states awarded by the Centers for Medicare & Medicaid Services (CMS). Missouri's state-led initiative, known as Transformation of Rural Community Health (ToRCH) Care and coordinated by the MO HealthNet Division within the Missouri Department of Social Services, received a $216 million award from CMS for the first year of the program. ToRCH Care is expected to build local partnerships, expand care coordination and build capacity through a “community hub” model. Rural hospitals, clinics and provider networks are expected to be the primary recipients of these funds. These investments are especially critical as hospitals face future reductions in Medicaid state-directed payments and provider tax matching rates, which disproportionately impact rural hospitals. Members can stay up to date on ToRCH Care and other Rural Health Transformation Program news, funding opportunities and resources on MHA’s Rural Health Transformation Program webpage.

This year's honorees — Barnes-Jewish Hospital, Citizens Memorial Hospital, Golden Valley Memorial Healthcare, Parkland Health Center–Farmington, Phelps Health, SSM Health St. Mary's Hospital–St. Louis, and Texas County Memorial Hospital — were recognized across five collaborative focus areas: severe hypertension in pregnancy, obstetric hemorrhage, maternal-infant dyads affected by substance use disorder, perinatal mental health conditions and cardiac conditions in obstetric care.

An average of 68 Missouri women died while pregnant or within one year of pregnancy each year over five years (2019-2023), with the highest number recorded in 2020 (85 deaths). The top three leading causes of death did not change from last year’s report: cardiovascular disease, mental health conditions and infection. Other key findings include the following.

• The pregnancy-related mortality ratio was 31.2 deaths per 100,000 live births.  
• The PRMR for Black women was 61.9 deaths per 100,000 live births, 2.5 times the PRMR for white women. This rate is similar to the 2024 and 2025 reports.
• The PRMR for Medicaid enrollees was 2.9 times the ratio of those with private insurance.  
• All pregnancy-related deaths due to mental health conditions, including substance use disorder, were determined to be preventable. Seventy-nine percent of all pregnancy-related deaths were determined to be preventable. 

The Missouri Hospital Association sponsors the Missouri Perinatal Quality Collaborative in association with DHSS. The MO PQC provides access to evidence-based initiatives, technical support, education and resources to support the reduction of severe maternal and infant morbidity and mortality. Quality improvement collaboratives, which align with key MO PAMR findings and recommendations, are deployed for more complex topics and are designed to result in highly reliable processes and improved care outcomes.

The newest edition of PolicyHuddle explores the progress occurring in maternal health improvement, including how the Missouri Perinatal Quality Collaborative is creating opportunities for better care and health for expecting and new mothers in Missouri.  

The episode features Dr. Karen Florio, Vice Chair of Patient Safety and Quality Improvement at the University of Missouri School of Medicine in Columbia, Mo., Dr. Niraj Chavan, Associate Professor of the Division of Maternal Fetal Medicine, at Saint Louis University, and Alison Williams, Division Vice President of Clinical Quality Affairs at the Missouri Hospital Association, who leads the Missouri PQC.  

In March, MO PQC in partnership with MHA, released its 2023-2025 progress report. Since 2023, participating hospitals and partners have advanced systems that improve patient safety, operational performance and long-term health outcomes, including:  

• faster treatment of severe high blood pressure, reducing the risk of stroke, seizures and long-term cardiovascular disease
• a 29% reduction in babies diagnosed with neonatal abstinence syndrome, helping shorten hospital stays and reduce NICU utilization
• nearly universal hemorrhage risk assessments, a foundational step in preventing shock, organ failure and maternal death
• stronger postpartum follow-up, improving care during the months when preventable deaths occur
• evidence-based safety practices embedded into daily care, not just policies on paper 

In the episode, the panelists discuss how the implementation of patient safety bundles has improved clinical care and how initiatives like Ask Me 5 are changing patient-clinician engagement to identify and mitigate pregnancy and postpartum risk.  

This edition of PolicyHuddle is less than 18 minutes in length and available online or on your favorite podcast platform. 

MHA is collecting stories about hospitals’ health improvement efforts. Please share examples of how your hospital or health system is working to implement your community health needs assessment or partnering with local organizations to address health challenges locally.

When you share stories on social media, please use the hashtag #MoHospitalsCare to help us identify and amplify your efforts. In addition to sharing on social media, we’ll include select stories in our multimedia campaign to broaden awareness at MissouriHealthMatters.org.

The Missouri Perinatal Quality Collaborative, in partnership with the Missouri Hospital Association, released its 2023-2025 progress report. Leveraging MHA’s ability to convene critical partners and expertise to solve complex problems, both state and federal partners have funded much of the recent work, allowing MO PQC to help hospitals, health systems and community organizations improve maternal and infant health and collaborate to better serve patients and communities.

MO PQC’s work is delivering results that are measurable, meaningful and saving lives. Since 2023, participating hospitals and partners have advanced systems that improve patient safety, operational performance and long-term health outcomes, including:

• faster treatment of severe high blood pressure, reducing the risk of stroke, seizures and long-term cardiovascular disease
• a 29% reduction in babies diagnosed with neonatal abstinence syndrome, helping shorten hospital stays and reduce NICU utilization
• nearly universal hemorrhage risks assessments, a foundational step in preventing shock, organ failure and maternal death
• stronger postpartum follow-up, improving care during the months when preventable deaths occur
• evidence-based safety practices embedded into daily care, not just policies on paper

The progress outlined in the report reflects the collective work of stakeholders committed to safer births, better outcomes and more resilient systems of care. To learn more about the MO PQC or get involved, visit mopqc.org or contact mopqc@mohospitals.org.

The Missouri Perinatal Quality Collaborative team traveled to Chesterfield, Mo., to co-host the 2026 Maternal and Infant Health Convening: Navigating Pathways Forward, held March 4-5.

Attendees from across the state enjoyed two days of learning, collaboration and action. From Dr. Michael Warren’s keynote on national trends to breakout sessions on clinical, community and policy topics, attendees heard from a variety of experts in maternal and infant health.

The resource hub and poster walk also connected guests with innovators, community partners and researchers who are transforming care.

The MO PQC is thankful for the collaboration with Missouri Foundation for Health, the Uplift Connection and the Missouri Department of Health and Senior Services to make this event a success.

Missouri Hospital Association and Missouri Perinatal Quality Collaborative staff attended Rural Health Advocacy Day held Feb. 24 at the Missouri State Capitol. The event brought together advocates, health care providers and community members to meet with lawmakers and their staff to discuss priorities for rural health.

Discussion topics included implementation of Missouri’s recently approved budget for its $216 million initial Rural Health Transformation Program award, proposed bills that would impact rural health care, state budget priorities, rural hospital sustainability, health care workforce shortages and access to care in Missouri’s rural communities.

“Rural Health Advocacy Day brought Missouri’s most pressing rural challenges into sharp focus, and MHA is leading the push for real solutions by elevating key issues and amplifying the unified voice of rural hospitals,” said Stephen Njenga, MHA’s director of quality measurement and population health improvement. “These hospitals anchor their communities, and MHA is ensuring they have the support needed to keep vital care local.”

Also in attendance, MO PQC highlighted its ongoing work to support rural obstetrics and postpartum efforts in Missouri. With more than half of Missouri counties classified as maternal care deserts, MO PQC is bridging gaps by hosting rural convenings statewide and creating a pool of OB emergency trainers. In 2025, the MO PQC provided $16,000 in rural stipends to support rural maternal health care. Rural teams are leveraging their emergency departments, EMS, community-based organizations and connections to higher levels of care, ensuring they are prepared to stabilize and save the lives of mothers and babies.

Rural hospitals face unique challenges — from workforce shortages to financial and infrastructure barriers — and MHA supports the state’s rural hospitals through advocacy, resources and ongoing evaluation to strengthen the health of rural communities.

MHA also is the convener of the Rural Hospital Council, which guides MHA’s policy, advocacy and services for rural and critical access hospitals.

• discussing information and recommendations from the Missouri Optimizing Postpartum Care Task Force
• highlighting local efforts to improve postpartum care delivery  
• creating connections between attendees interested in improving postpartum care 
   

Hospital and health care leadership are encouraged to attend, as well as those providing care during the one-year postpartum period, including physicians, nurses, community-based organizations, doulas, midwives, birth workers, psychiatrists, therapists, peer support specialists and more.

Dinner is complimentary for attendees. Spots for these dinners are limited, so we encourage you to register for the dinner nearest you. 

The partnership offers a variety of programs and resources to support pregnant and postpartum patients, as well as newborns. For instance, the HCCH social service team is working to improve encounters with patients by utilizing the Ask Me 5 framework developed by the Missouri Perinatal Quality Collaborative in partnership with MHA. 

HCCH and NKC Health report signs of improvement in maternal care through the partnership. They highlight a critical step forward in the program that has been preventing expectant moms from going without any prenatal care. Since the collaboration began, NKC Health has seen a 37% drop in the number of patients in the rural Northwest Missouri program delivering without any prenatal care. 

“The partnership has created a seamless experience for patients while supporting clinical teams on both ends,” said Robin Hogan, R.N./BSN, HCCH medical clinics director. “Watching this program grow and thrive has been both rewarding and energizing for everyone involved.” 

MHA equips hospital teams with knowledge and tools, like Ask Me 5, that advance high-quality care and, ultimately, improved health outcomes. Learn more about the value of membership and how MHA is a trusted partner of Missouri’s hospitals. 

In the past four years of evaluating the causes of maternal deaths in Missouri, the Missouri Pregnancy-Associated Mortality Review Board found that more maternal deaths occurred between 43 and 365 days postpartum than during pregnancy or the fourth trimester (through 12 weeks postpartum).

Given the challenges within the current maternal health landscape, further efforts are called for to redefine the spectrum of postpartum care, especially in light of a lack of current professional guidelines and standards of care past the fourth trimester.

In partnership with the Missouri Hospital Association and the Missouri Department of Health and Senior Services, the Missouri Perinatal Quality Collaborative convened the Missouri Optimizing Postpartum Care Task Force, which developed The One-year Postpartum Pathway to further broaden the definition of the postpartum period and outline the standards for and continuity of postpartum care through the full 12 months post-delivery. An executive summary of the report also is available.

The MO PQC will host a webinar about “The One-Year Postpartum Pathway” at noon Monday, Dec. 15. All audiences interested in postpartum care are invited to register.

This rule establishes the requirements for facilities to receive matching funds for the installation of newborn safety incubators such as those utilized in Safe Haven Baby Boxes in fire stations and hospitals.

Under the new regulation, providers can receive as much as $10,000 in state matching funds to help with installation costs for newborn safety incubators. The proposed rule language can be found on DHSS’ website, and statutory authority governing the program can be found in 210.950, RSMo.

• clinical providers
• community-based providers
• public health professionals
• child protective services and juvenile court staff
• peer recovery specialists

Stakeholders are encouraged to share this survey with colleagues. Survey results will be shared through the MO PQC in 2026. 

Survey participation will help determine future training and programming efforts for providers who work with mothers experiencing SUD. Participants who provide their email at the end of the survey will be entered into a random drawing for one of five $100 Amazon e-gift cards (delivered directly via email). All responses will be kept confidential and separate from participants’ email addresses.

MO HealthNet will host office hours on the following days to discuss the changes and answer any questions from providers.

• Tuesday, Oct. 7, from 11 a.m. to noon | Register here
• Wednesday, Oct. 8, from 11 a.m. to noon | Register here

Questions also can be emailed to MHD.NOP@dss.mo.gov.

About 80% of all pregnancy-related deaths in Missouri are preventable, according to the 2025 Pregnancy-Associated Mortality Review Annual Report.

The Missouri Perinatal Quality Collaborative, in partnership with the Missouri Hospital Association, is working to change that with a statewide initiative called Ask Me 5.

The idea for Ask Me 5 began when the Missouri PAMR board, which reviews all cases of maternal death from conception through one year postpartum, began seeing the same five concerns recur in these preventable deaths, according to Alison Williams, DNP, MBA-HCM, CPHQ, LSSGB, vice president of clinical quality improvement at MHA and the team lead for the MO PQC.

“We weren't having good conversations with our patients, so we decided we really needed to do something about that,” she said.

With a goal of improving maternal health outcomes during pregnancy and the postpartum period, Ask Me 5 encourages health care providers to ask their patients five essential health questions that build trust, open dialogue and address critical health concerns.

The five questions are outlined in an easy-to-recall acronym: H.E.A.R.T.

• High blood pressure/preeclampsia: Have you ever been told you have high blood pressure or preeclampsia?
• Emotional and mental health: How have you been feeling lately?
• Access to health care: Are there obstacles that make it difficult to attend appointments?
• Recognizing substance use: Can we discuss your experience with alcohol or drug use?
• Trauma, abuse and safety: Do you feel safe in your home, both emotionally and physically?

These questions were developed to help providers and patients have more open, authentic and nonjudgmental conversations that are based on five highly preventable causes of death in mothers in Missouri, Williams said.

“We developed the Ask Me 5 framework and the H.E.A.R.T. acronym to better support providers and patients when it comes to saving lives and improving the health of moms and babies,” Williams said. “Being more intentional and talking about these areas of concern better enables providers to help expectant moms find solutions, which leads to better birth outcomes.”

The MO PQC crafted this initiative but didn’t do it alone.

“The MO PQC has a wider network called our Maternal-Child Learning and Action Network, which consists of clinical professionals, state- and community-based organizations, birth workers, patients, and various maternal and infant stakeholders throughout the state,” Williams said.

In addition, MO PQC staff asked a patient focus group for feedback about Ask Me 5.

According to Williams, Ask Me 5 encourages maternal and infant health care providers to raise these concerns with patients through a conversation built into existing workflows. She added that not all five questions must be asked at one patient visit, but providers should keep in mind that they need to cover these topics with their patients early and often from pregnancy through postpartum.

“Some of these issues can make people feel very isolated. We just want these patients to know that they're not alone, and we're here to help,” said Mary Conley, perinatal quality collaborative engagement specialist at MHA.

By asking questions designed around H.E.A.R.T., providers can address sensitive topics with patients, provide them with resources, and empower them to understand and prioritize their health during pregnancy and the postpartum period.

“These questions can be asked by any provider of maternal or infant care services,” Williams said.

While pediatricians have a duty to evaluate infants and children, they also have the opportunity to connect with the mother and check on her while they’re in the same room. Doulas and public health and community-based workers  who come in contact with pregnant or postpartum patients can ask these questions, too.

“Providers should know that having these conversations is better for everyone. The information they elicit from their patients helps them better care for their patients and helps the patients have a better care experience,” Williams said.

Dr. Niraj Chavan is a Missouri health care provider who uses the Ask Me 5 conversation tool. Chavan has a master’s degree in public health and is an associate professor of the Department of Obstetrics, Gynecology and Women’s Health at Saint Louis University; PAMR board member; maternal chair of MC LAN; and medical director of the Women and Infant Substance Help Center at SSM Health. 

“The Ask Me 5 campaign really equips us, as providers, in being able to understand and identify, ‘Are there things that are not going right? Are there issues that need to be addressed?’” Chavan said.

Williams said data show that Missouri has one of the highest maternal mortality rates in the country. She noted that Ask Me 5 equips providers and patients to have meaningful conversations that can save lives.

Williams and Chavan urge providers to utilize Ask Me 5 to help reverse Missouri’s maternal mortality rates.

“What I would say to every provider out there is that if you want to be part of this process, part of this change to impact the lives of moms and babies across Missouri, use Ask Me 5,” Chavan said.

The MO PQC offers training materials that can help providers feel more comfortable having conversations about these sensitive topics.

A free workshop scheduled for Tuesday afternoon, Oct. 28, at the 2025 MO PQC Maternal & Infant Symposium will discuss the Ask Me 5 initiative. Attendees at the workshop also will have an opportunity to learn about Ask Me 5 Ambassadors, a program for passionate supporters dedicated to educating others about Ask Me 5 and spreading awareness on ways to address maternal morbidity and mortality. 

To learn more about Ask Me 5, visit MO PQC’s website to access free resources, including provider and patient booklets, posters, reference cards and video trainings.

Listen to Williams and Conley discuss the Ask Me 5 initiative on MHA’s PolicyHuddle podcast.

The Ask Me 5 initiative, created by the Missouri Perinatal Quality Collaborative, is helping providers as well as patients and their support system initiate difficult conversations that can lead to better care and health, while improving maternal health outcomes during pregnancy and the postpartum period. This episode features Alison Williams, MHA vice president of clinical quality improvement, and Mary Conley, perinatal quality collaborative engagement specialist.

PolicyHuddle is available online or on your favorite podcast platform.

A short informational video, a PowerPoint presentation outlining the changes and FAQs are available online. Any questions regarding the new process can be emailed to MHD.NOP@dss.mo.gov.  

During this interim period, Pfizer is implementing its Medical Request Process to ensure the product is distributed equitably to hospitals and clinics treating patients with the highest medical necessity. On July 14, the FDA revised a drug shortage notice for Bicillin, indicating delay in shipment of the drug as the reason for the shortage.

This recall and potential shortage are of particular concern as Bicillin L-A is the only drug recommended for the treatment of syphilis during pregnancy. For other uses of Bicillin L-A, such as treatment of strep throat or other bacterial infections, alternatives such as doxycycline can be used.

Treatment of syphilis in pregnant individuals is critical to prevent the spread of infection to the newborn, also known as congenital syphilis. If not treated, syphilis during pregnancy can cause low birth weight, miscarriage, stillbirth and other adverse effects in newborns. Increased rates of congenital syphilis may be further complicated by the potential shortage of Bicillin, especially with the antibiotic being a key part of the strategy to attempt to reduce rates. 

Missouri has seen a sharp increase in rates of congenital syphilis since 2019, with the Missouri Department of Health and Senior Services issuing a health update in February 2024.

More than just numbers, these reviews help uncover the stories behind maternal deaths — why they happen, who they affect, and most importantly, what can be done to prevent them. In the latest blog from the Missouri Perinatal Quality Collaborative, the MO PQC team reviews the report, discusses what the MO PQC is doing to improve outcomes for birthing people in Missouri, and outlines what comes next in their work to improve maternal health outcomes.

An average of 70 Missouri women died while pregnant or within one year of pregnancy each year over five years (2018-2022), with the highest number recorded in 2020 (85 deaths). Mental health conditions, including substance use disorders, were the leading underlying cause of pregnancy-related deaths, followed by cardiovascular diseases. Other key findings include the following.

• The pregnancy-related mortality ratio was 32.3 deaths per 100,000 live births.  
• The pregnancy-related mortality ratio for Black women was 2.5 times the ratio of white women. This is a decline from the previous three reports.  
• All pregnancy-related deaths due to mental health conditions, including substance use disorder, were determined to be preventable. Eighty percent of all pregnancy-related deaths were determined to be preventable. 
• Women living in micropolitan counties had the highest ratio of pregnancy-related deaths (38.7 per 100,000 live births). 

MHA sponsors the Missouri Perinatal Quality Collaborative in association with DHSS. The MO PQC includes access to evidence-based initiatives, technical support, education, and resources to support the reduction of severe maternal and infant morbidity and mortality. Quality improvement collaboratives, which align with key MO PAMR findings and recommendations, are deployed for more complex topics and are designed to result in highly reliable processes and improved care outcomes.

• Fifteen health care facilities received $10,000 stipends for implementing universal SBIRT (screening, brief intervention and referrals to treatment) and Eat, Sleep, Console models for pregnant and postpartum patients with substance use disorders and infants born with neonatal abstinence syndrome.
• Seven hospitals and organizations received $5,000 stipends to support implementation of universal SBIRT for postpartum patients with mental health conditions and SUD.

These stipends support reducing maternal mortality, which is a priority initiative within MHA’s strategic plan and the state’s Maternal Mortality Prevention plan. As data from the Missouri Pregnancy Associated Review shows, mental health conditions, including SUD, make up a large percentage (28%) of maternal death in the state. The work of these Missouri hospitals and health care organizations to improve screening for moms and babies goes hand in hand with the MO PQC’s efforts to support evidence-based practices in maternal and infant health care.

The MO PQC would like to recognize the following organizations for their work in screening for SUD, mental health conditions, and postpartum health:

• Barnes-Jewish Hospital
• Citizens Memorial Hospital
• Fitzgibbon Hospital
• Freeman Health System
• Golden Valley Memorial Healthcare
• Hannibal Regional Hospital
• Korédé House
• Mercy Hospital Springfield
• Mercy Hospital St. Louis
• Mercy Women and Children – Chesterfield
• Mosaic Life Care at St. Joseph Medical Center
• Mosaic Medical Center – Maryville
• Obstetrics & Gynecology – WashU Medicine
• Parents as Teachers – Crocker
• Parkland Health Center – Farmington
• Perinatal Behavioral Health Service – Washington University in St. Louis
• Saint Francis Healthcare System
• Scotland County Hospital
• SSM Health St. Mary’s Hospital – St. Louis
• Ste. Genevieve County Memorial Hospital
• University Health – Kansas City
• Western Missouri Medical Center

Missouri Gov. Mike Kehoe on May 7 signed a proclamation declaring May as Parental Mental Health Awareness Month across the state of Missouri. This is the first statewide awareness month for parental mental health in the country. 

The proclamation recognizes the high prevalence of perinatal mental health conditions, such as postpartum depression and anxiety, in Missouri communities and encourages the destigmatization of mental health concerns for parents of all kinds, regardless of race, nationality, sexual orientation, gender, age or ability.

Postpartum depression is the most common, yet most underdiagnosed obstetrical complication in the country — affecting nearly 20% of new and expectant mothers/birthing persons and at least 10% of fathers and partners. In Missouri, mental health conditions, including substance use disorders, are the leading underlying cause of pregnancy-related deaths. Data show that all pregnancy-related deaths due to mental health conditions are preventable. 

This proclamation is a significant step forward in acknowledging the rates of postpartum depression and other perinatal mental health conditions in Missouri and the importance of support needed before, during and after pregnancy. 

The Missouri Hospital Association and the Missouri Perinatal Quality Collaborative, Whole Parent Foundation, and the Missouri Department of Health and Senior Services were represented at the proclamation signing with Gov. Kehoe.

The new scorecard introduces provider-level data using National Provider Identifier (NPI) information. Built to support hospital QI teams — not for use in credentialing or punitive review — this feature is designed to encourage peer engagement and collaborative reflection on outcomes data.

Using a four-level drill down format, users can explore blinded statewide participating hospital trends, zoom into their hospital-specific data, view unadjusted rates by attending physicians (for those with 25+ cases) and access patient-level details to guide internal review processes.

Key highlights for the update include:

• clear visualization of unadjusted SMM rates by provider
• contextual information such as risk stratification and NPI taxonomy
• a tool to support root cause analysis, chart review and evidence-based practice alignment

Importantly, SMM and other outcome rates are not risk-adjusted and are intended for descriptive, not comparative use. Providers are encouraged to interpret trends with an understanding of the many factors that contribute to maternal outcomes, including clinical practices, team dynamics and patient-level risk factors.

This update reflects the Missouri Hospital Association’s and the PQC’s shared commitment to providing tools that support safer birth outcomes and elevate maternal health across Missouri. As hospitals continue to implement maternal safety bundles and improvement strategies, this expanded view will help drive conversations that lead to better outcomes for birthing individuals and babies. Users may view their specific Tableau-based dashboard through the Hospital Industry Data Institute’s Care Optics^® platform by signing into the HIDI Advantage^® user portal or by requesting access.

The Missouri Hospital Association recently hosted a critical care obstetric training event to expand clinicians’ skills at hospitals with limited critical care OB capacity. The training, funded through MHA’s partnership with the U.S. Department of Health and Human Services’ Office of the Administration for Strategic Preparedness and Response, is designed to support OB-specific care for critically ill pregnant patients, including fetal assessment, delivery and neonatal management.

Missouri’s significant OB deserts often result in patients presenting with critical conditions at hospitals with limited dedicated critical care OB resources. The training was designed to support immediate critical care assessment and management for pregnant patients, patient stabilization and — where appropriate — transport to the most appropriate care environment.

“In some parts of the state, the distance between home and high-acuity care can mean expecting mothers in medical emergencies need intensive care locally,” said Keri Barclay, MHA’s manager of clinical preparedness and coalition administrative liaison. “This program helps front-line clinicians leverage experts and tools to prepare for complex OB care for these patients.

OB caregivers from throughout the state attended the program. It included presentations and skill stations — using relevant equipment and training manikins — to share best practices and provide practical, hands-on training to guide clinical decision-making.

Mylee Hicks and Elena Beckman, registered nurses at Lake Regional Health System in Osage Beach, Mo., attended the training.

According to Beckman, the prevalence of poor health and chronic conditions results in more complex care for patients in the community she serves. Caring for pregnant patients in an intensive care unit setting is specialized and requires specific training and competencies.

“Pregnant women are dealing with higher acuity illnesses,” Beckman said. “Even at a small facility, we still have those patients walk in our door and have the need to stabilize them before sending them to a higher acuity facility.”

Hicks, a labor and delivery nurse, indicated that finding similar training for the critical care setting is difficult. She said that similar high-tech and high-touch training is hard to find, and as a newer nurse, she appreciates the opportunity to grow.

“There’s always room to learn,” Hicks said. “This class was extremely informative. There are a lot of things that we are hopeful to implement in our unit.” The training was part of MHA’s Fundamental Critical Care Support series that includes obstetrics, pediatrics and surgical coursework.

Progress West Hospital in O’Fallon, Mo., has been honored with the Missouri Hospital Association’s Aim for Excellence Award for efforts to improve care for expecting mothers through their Maternal Hypertension Collaborative. Established in 2016, the Aim for Excellence Award recognizes hospital innovation that improves patient outcomes. Progress West Hospital received the award on Nov. 14 at MHA’s 102nd Annual Convention in Kansas City, Mo.

“Maternal health improvement is a priority for hospitals and other stakeholders, as Missouri’s rate of maternal mortality and long-term harm, are in the bottom fifth of states,” said Jon D. Doolittle, MHA President and CEO. “Identifying systems to better address and mitigate problems like high blood pressure during pregnancy are important to delivering better health outcomes.”

Despite maternal hypertension’s leading role in significant maternal mortality and morbidity, only about half of pregnant women in Missouri presenting with sustained high blood pressure levels receive care within the recommended 60 minutes.

Progress West Hospital built on BJC HealthCare’s Maternal Hypertension Collaborative to establish a hospital-specific collaborative designed around visual process improvement reminders, provider engagement and medical record notations.

“Ultimately, the success of the project is attributed to creating a culture of multidisciplinary collaboration and teamwork,” said Heather Decker, Program Manager of Women and Infants at Progress West Hospital. “Keeping the patient at the center of everything we do ensures that we give care that is not only  safe, but extraordinary.”

The hospital’s goal for severe hypertension care was to achieve 90% compliance with best practices. After implementing the six-step process — including K-card visualization of process and progress — the team achieved nearly 100% compliance with treatment goals.

SSM Health’s Women and Infant Substance Help Center, or WISH Center, at SSM Health St. Mary’s Hospital — St. Louis has been honored with the Missouri Hospital Association’s Aim for Excellence Award. Established in 2016, the Aim for Excellence Award recognizes hospital innovation that improves patient outcomes. The WISH Center received the award on Nov. 14 at MHA’s 102nd Annual Convention in Kansas City, Mo.

SSM Health’s WISH Center provides comprehensive, high-risk maternity care for pregnant individuals affected by substance use disorders. Between 2014 and 2023, the center served more than 3,000 women.

“Improving maternal health outcomes can be challenging for individuals with substance use disorders,” said Jon D. Doolittle, MHA President and CEO. “Through the WISH Center, expecting mothers are navigated through substance use harm mitigation services, as well as provided wrap-around clinical and social services to improve outcomes for the mother and child.”

Using medication-assisted therapy as part of a broad risk-based approach to care, the WISH Center meets patients where they are — providing them with connections to outside organizations for job skills, housing, life skills, parenting skills and more. Engagement is end-to-end, with social and clinical services during pregnancy and birthing services through the hospital. In addition, the WISH Center provides patients with an AfterCare program for two years after childbirth to continue essential support.

“Our patients receive a comprehensive and holistic experience that prioritizes their needs in a non-judgmental environment,” said Niraj Chavan, M.D., medical director of the WISH Center at SSM Health St. Mary’s Hospital in St. Louis. “Mothers impacted by substance use and perinatal addiction often encounter numerous challenges, and we focus on addressing their overall well-being. This includes tackling unmet needs such as barriers to care, food and housing insecurity, psychosocial support, and the lack of family support. Our multilayered approach connects patients with the appropriate medical team members and support services, enhancing their chances of success.”

The program minimizes pregnancy-related complications and reduces the length of hospital stays for newborns. During that time, the average neonatal intensive care unit admission for children of WISH Center pregnancies dropped from 17.4 days to 6.9 days