Emergency Department Maternal Health Toolkit
You can be part of the solution! Heading link
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In Illinois, from 2018-2020, an average of 88 women/people died per year while pregnant or within one-year postpartum.1
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Illinois Maternal Mortality Review Committees (MMRCs) found that, from 2018-2020, 91% of pregnancy-related deaths were potentially preventable.2
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Of the people in Illinois who experienced a pregnancy-related death from 2018-2020, 66% had at least one ED visit.1
Footnotes Heading link
1Bergo, C. Maternal Mortality in Illinois: How Emergency Departments Can Help. IDPH Office of Women’s Health and Family Services. CityMatch Conference 2022 September.
You can be part of the solution! Heading link
Please note: this material is only available to the hospitals participating in the pilot of the Maternal Health ED Toolkit. The full materials will be released after the pilot is complete.
For inquiries about the Toolkit, complete this form.
About the Maternal Health ED Toolkit Implementation Guide Heading link
This guide will support you as you complete the Maternal Health Emergency Departmenet (ED) Toolkit. You will be guided to complete a pre-training questionnaire, 5 content-based modules, a post-training questionnaire, and receiving CME/Nursing Contact Hours credits. Each module component contains information on the module’s learning objectives, links to access the module videos, and additional resources to support your learning.
Critical Success Factors in the Emergency Department Heading link
- Display a sign in your ED alerting patients that they should inform ED staff of their pregnancy or postpartum status.
- Ask persons of reproductive age (10-55 years) if they are pregnant or within one year postpartum.
- Document their pregnancy or postpartum status in the patient’s chart. For example, if available, check the EMR box for pregnant or postpartum status, or add a note to the chart.
- Treat patients who are pregnant or within 1 year postpartum in accordance with the guidelines in the toolkit modules.
Resources Heading link
Instructions Heading link
*If you cannot remember your Anonymous Response ID, please search your email inbox and SPAM folder for the subject line “Maternal Health ED Toolkit – Response ID Number” or reach out to kcraem2@uic.edu or eglass2@uic.edu for further assistance.
Complete a pre-training questionnaire, 5 modules, and a post-training questionnaire
- You must start with the pre-training questionnaire. You will receive an Anonymous Response ID after completing the pre-training questionnaire. This Anonymous Response ID will grant you access to each module. Save this ID*.
- After watching each module, you will need to certify that the module is complete in Qualtrics to receive credit.
- Once you’ve completed the pre-training questionnaire and watching the Introduction module, you can complete the modules in any order. We recommend you watch each module in the order they appear.
- The modules can be completed online, in-person, or a combination of both.
Set aside approximately 3.5 hours to complete the training.
Please note that you do not need to complete the training all at once.
- The entire Maternal Health ED Toolkit does not need to be completed in one sitting, but each individual module cannot be paused to be finished later. Be sure to set aside enough time to complete the module at one time. Module B is available in 20-30 minute components.
- The estimated time to complete each module is:
- Introduction: 08 minutes
- Module A: 14 minutes
- Module B: 133 minutes
- Module C: 31 Minutes
- Module D: 28 minutes
- Module E: 12 minutes
Each section below will guide you through each step
You will find the following information in each section:
- The learning objectives of each module.
- The links to each module’s video(s).
- Resources associated with each module.
Maternal Health ED Toolkit Heading link
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Pre-Training Questionnaire
The pre-training questionnaire responses are anonymous and seen only by the CRWG research team. No workplace associates or colleagues will have access to any of your responses.
You will receive your Anonymous Response ID after completng the pre-training questionnaire. You will need to enter your Anonymous Response ID to gain access to each module. Don’t forget to save your ID for easy access!
Estimated time to complete: 10 minutes
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Introduction: Improving Maternal Health: The Role of Emergency Departments
The Introduction provides an opening to the Toolkit, an overview of each module, and reviews the critical success factors you and your emergency department can take to improve maternal health in Illinois.
Please note while completing this training program: This training recognizes that not all people who have been pregnant or given birth identify as being a “woman.” This toolkit uses the term “women” instead of “people” or “persons” as an intentional device to highlight the vulnerability of the people who society typically identifies as being female. The use of “women” is not intended to exclude or silence those who do not identify as female, but to draw attention to the ways pregnant or postpartum people are discriminated against because of their female assignment at birth.
Estimated time to complete: 10 minutes.
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Module A
Module A Information
Module A outlines the current state of maternal health in Illinois. We give a thorough explanation of where the current data comes from, how emergency departments play a key role in the care of pregnant and postpartum patients, and what we can do together to help improve maternal health in Illinois.
Estimated time to complete: 14 minutes.
Module A Learning Objectives
- Describe the Illinois maternal mortality review process.
- Describe the prevalence of emergency department (ED) use among Illinois maternal deaths.
- Discuss the missed opportunities in the ED.
- List the recommendations for EDs to address maternal health.
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Module B
Using a Respectful Maternity Care approach, Module B combines the Emergency Severity Index, the Maternal Early Warning Criteria, and the Maternal Fetal Triage Index into the Perinatal Triage Algorithm for the triage of pregnant and postpartum patients in the ED.
Module B contains an introduction and 5 case studies, all of which are required to receive CME/Nursing Contact Hours credits at the end of the training. There is also an additional optional submodule, “Additional Case Studies: Assessing Acuity.” While not required for full completion of the trianing, we highly recommend taking the time to watch “Additional Case Studies: Assessing Acuity.” All required modules are denoted with a “*” below.
We recommend having the Perinatal Triage Algorithm printed, or open on your device, while working through all of the submodules for Module B.
Total approximate time to complete is: 133 Minutes. The breakdown of the total approximate time to complete Module 2 is:
- Module B1: Acuity Assessment and Management of Perinatal Emergencies (23 minutes)*
- Module B2: Case Study – Jamie (22 minutes)*
- Module B3: Case Study – Maya (21 minutes)*
- Module B4: Case Study – Carrie (27 minutes)*
- Module B5: Case Study – Jessica (22 minutes)*
- Module B6: Case Study – Marie (18 minutes)*
- Additional Optional Case Studies – Assessing Acuity (13 minutes)
Module B Learning Objectives
- Explore how to incorporate perinatal patients into an ED acuity system.
- Identify the Obstetric Warning Signs
- Consider how to integrate knowledge and apply skills in the recognition and management of the compromised obstetric patient.
- Watch Module B1: Acuity Assessment and Management of Perinatal Emergencies
- Watch Module B2: Case Study – Jamie
- Watch Module B3: Case Study – Maya
- Watch Module B4: Case Study – Carrie
- Watch Module B5: Case Study – Jessica
- Watch Module B6: Case Study – Marie
- Watch Optional Additional Case Studies – Assessing Acuity
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Module C
Module C discusses the next practice for conducting universal screening for depression, anxiety, and suicide risk, as well as screening for SUD/OUD. Module C also gives guidance on assessing the need for in-patient level of care for safety concerns and stabilization.
Total approximate time to complete is: 31 minutes.
Module C Learning Objectives
- Recognize how to conduct universal screening for depression, anxiety, and suicide risk.
- Understand how to respond to pregnant and postpartum patients with depression, anxiety, and suicide risk.
- Recognize how to conduct universial self-report screening for substance use disorder/opioid use disorder.
- Understand how to respond to pregnant and postpartum patients with substance use disorder/opioid use disorder.
Module C Resources
- MAR NOW Factsheet
- MOMS Hotline Flyer (English)
- OUD Helpline Communication Campagin For OB And ED Units
- Patient Education For Narcan
- Drug Overdose Prevention Program
- Patient Education Resource On OUD And Pregnancy
- Pregnant/Postpartum OUD Algorithm For EDs
- ILPQC Save A Life Narcan/Naloxone Flyer
- Screening For Anxiety Algorithm
- Screening For Depression Algorithm
- Opioid Use Disorder (OUD) Screening Methods and Resources for Emergency Department Providers
- Opioid Use Disorder (OUD) Screening Methods and Resources for Perinatal Providers
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Module D:
Module D gives guidance for treating pregnant patients who have experienced trauma. Module D discusses best practices for treating trauma in pregnancy, including early warning signs of various instances of trauma, and how to address the warning signs for the best possible outcome of both the pregnant person and the fetus.
Total estimated time to complete is: 28 minutes.
Module D Learning Objectives
- Demonstrate the procedure for continuous uterine displacement during CPR of a pregnant person.
- Recognize potential etiologies of maternal cardiac arrest.
- Cite examples of pregnancy-related anatomic and physiologic changes that affect management of an injured pregnancy persons.
- Outline the timeframe and criteria for when to perform a perimortem cesarean section during management of cardiac arrest of a pregnant person.
- Explain the two outcome goals for performing a perimortem cesarean section.
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Module E
Module E goes through the proper ED discharge, the proper steps to follow to ensure timely follow up, and provides key resources for pregnant and postpartum patients.
Total approximate time to complete: 12 minutes.
Module E Learning Objectives
- Determine follow-up time after discharge from the ED.
- Complete Discharge Checklist.
- Engage in hand-off and provide care coordinate.
- Provide patient with resources.
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post-training questionnaire
The post-training questionnaire responses are anonymous and seen only by the CRWG research team. No workplace associates or colleagues will have access to any of your responses.
Estimated time to complete: 10 minutes
CME/Nursing Contact Hours Credit Information
After you complete all of the modules and the post–questionnaire, the final screen of the questionnaire includes a link to an evaluation questionnaire to receive the option of 3 CME credits or nursing contact hours. You will also be automatically sent an email with the CME/nursing contact hour evaluation questionnaire after you complete the post–questionnaire. Completion of the CME/nursing contact hours evaluation questionnaire is required to receive credits.
Due to processing stipulations for CME credits by ACCME, certificates of completion will be distributed as soon as possible following the close of this activity. This CME activity will close in April 2024. Please note that per ANCC, nursing contact hour certificates are allowed to be distributed following evaluation and will be sent after completion of the post–questionnaire.