Hypertensive disorders of pregnancy are a leading cause of severe maternal morbidity (SMM) and mortality and studies have shown that more than 60% of cases are preventable. As part of a state-wide quality maternal safety quality improvement project (MSQIP), we adapted the Alliance for Innovation on Maternal Health (AIM) Severe Hypertension in Pregnancy bundle in a consortium of maternity hospitals in [REDACTED] to improve care processes and outcomes for patients with a severe hypertensive event during pregnancy or postpartum period. To report the first year of data from this MSQIP, including an assessment of the process measures by hospital level of maternal care designation, and provide perspective on the unique challenges of implementing a large-scale MSQIP during a global pandemic. This MSQIP engaged [REDACTED] Level I-IV maternity hospitals and provided multimodal QI support. Participating hospitals submitted monthly patient level data, which included all cases of new onset sustained severe hypertension. The primary process measure was the proportion of birthing persons in [REDACTED] with sustained severe hypertension who received treatment with appropriate acute antihypertensive therapy within 60 minutes. Secondary process measures included receipt of: a follow-up appointment after hospital discharge within 72 hours (if discharged on medication) or 10 days (if discharged without medication), a blood pressure cuff on hospital discharge, and education about urgent maternal warning signs. Data for primary and secondary process measures were plotted on a biweekly basis and statistical process control methods were used to identify special cause variation over time. Data were stratified by various demographic variables, including race/ethnicity, insurance status, and maternal level of care. To assess the impact of the COVID-19 pandemic on this MSQIP, process measure data was compared to COVID-19 case volume in [REDACTED] across the study epoch. Twenty-nine hospitals participated in the project from July 2020 through September 2021. Data was collected on 4,948 hypertensive events representing 4,678 unique patients. In aggregate, the primary process measure (timely and appropriate treatment) demonstrated a 19.3% increase (from baseline of 56.5% to 67.4%, p < 0.001). The secondary process measures demonstrated significant increases ranging 26.1% to 166.8% (all p < 0.001). Both non-Hispanic Black and White pregnant or postpartum people demonstrated shifts and sustained improvements in the treatment of severe hypertension, which did not differ by race across the study period. Notably, process measure improvements were achieved and sustained across peaks in the COVID-19 pandemic. This [REDACTED] MSQIP demonstrated meaningful changes in project process measures in the identification and treatment of severe hypertension in pregnancy and the postpartum period. Process measures improvements were achieved across all hospital levels of maternal care and differences were not observed by race or ethnicity. Our findings suggest that a robust and comprehensive QI initiative with appropriate support and resources can achieve meaningful gains in the setting of a global pandemic.