1137 Improving outcomes for mothers affected by opioids across diverse hospitals through statewide quality improvement

Abstract

The Illinois Perinatal Quality Collaborative (ILPQC) launched a Mothers and Newborns affected by Opioids quality improvement (QI) initiative in May 2018 to increase OUD screening with a universal validated self-report tool and optimize care for pregnant patients with opioid use disorder (OUD) in participating hospitals. The objective of this analysis is to assess improvement in OUD identification and treatment. Hospitals reported monthly key measures, including a random sample of 10 deliveries per month to evaluate screening and all patients with OUD at delivery. ILPQC facilitated collaborative learning opportunities, rapid-response data, and QI support. Generalized linear mixed effects models were used to determine whether the rate of achievement of optimal OUD care improved over time (6 month increments from July 2018 to June 2020) adjusted for hospital characteristics. 84 hospitals reported 19,220 patients from the screening sample and 2,276 patients with OUD at delivery. Data showed significant improvement across the initiative linking patients to medication assisted treatment (MAT) and recovery treatment services and providing Narcan counseling by discharge, regardless of hospital characteristics (Tab 1). The rate of patients with OUD on MAT increased by 9% every 6 months from 40.4% to 56.6% (p=0.002). The rate of patients with OUD receiving Recovery Treatment Services increased by 7% every 6 months from 46.7% to 79.4% (p=0.001). The rate of patients with OUD receiving Narcan counseling increased 49% every 6 months from 4.8% to 33.6% (p<0.001). A monthly sample of deliveries showed a significant increase in the percent of patients screened with a validated OUD screening tool with estimated median increase 78% (61%, 92%) from 12.1% to 91.6% (p<0.001) (Fig 1). A statewide QI effort to improve care for pregnant patients with OUD significantly improved validated screening for OUD and optimal OUD care including linkage to MAT and recovery treatment services, and receiving Narcan counseling across diverse IL hospitals regardless of hospital characteristics.View Large Image Figure ViewerDownload Hi-res image Download (PPT)