‘Raising the Bar for Maternal Health Equity and Excellence’ Partners With Two NJ Hospitals, Creates Perinatal Community Advisory Boards
TRENTON, New Jersey — The New Jersey Health Care Quality Institute has partnered with two hospitals to launch “Raising the Bar for Maternal Health Equity and Excellence,” a two-year initiative to improve birth equity, maternal child outcomes, and the experiences of people giving birth.
The Quality Institute — with Capital Health Medical Center – Hopewell and Penn Medicine Princeton Medical Center — is one of the first in the nation to implement recommendations from the National Partnership for Women & Families’ guide, Raising the Bar for Maternal Health Equity and Excellence: Actionable Strategies for Healthcare Systems.
Raising the Bar recognizes that health care institutions such as hospitals can play a pivotal role in reversing the nation’s maternal health crisis by advancing respectful and equitable health care. Maternal mortality has risen in the United States in the past two decades even as maternal deaths have declined around the world, with pregnancy-related mortality significantly higher for Black women than white women.
"I am delighted to witness these pilots of our recommendations,” said Sinsi Hernández-Cancio, Vice President for Health Justice at the National Partnership for Women & Families, who oversaw the creation of the guide. “Our goal was to offer a variety of strategies to tackle the depth and complexity of the maternal health crisis. These Perinatal Community Advisory Boards — working directly with community members who have critical knowledge, expertise, and experience — are a potential game-changer for maternal health.”
The Robert Wood Johnson Foundation funded Raising the Bar and is supporting the Quality Institute in creating this pilot with the goal of creating transformational impact in maternal health in the Greater Mercer County area — and with the potential to expand successful strategies. More Raising the Bar initiatives are planned nationally. Other health care institutions are encouraged to use the guide now as they work toward developing short-term and long-term strategies to improve their maternal health outcomes.
The Raising the Bar national report, released in 2023, outlines four core roles where health care institutions can advance equitable maternal health care: as providers of care; as employers; as community partners; and as advocates. The Quality Institute pilot is focused on the role of hospitals as health care providers and as community partners.
The Quality Institute reached out to both hospitals last year, and leadership at both institutions enthusiastically embraced the opportunity to work with the Quality Institute on Raising the Bar. Since then, the Quality Institute and the hospitals have worked closely together.
“As a partner in the initiative, Penn Medicine Princeton Health will continue to prioritize the health and well-being of our patients to ensure positive maternal child outcomes. By engaging with patients at the bedside throughout labor and delivery, we can help empower them to have the birthing experience that they desire,” said Christina G. DiVenti, MD, Medical Director, Labor and Delivery and Mother Baby units at Penn Medicine Princeton Health. “This initiative also supports our recent Joint Commission Advanced Perinatal Certification, which reinforces our commitment to health equity and maternal safety.”
One key element of the initiative is the creation of Perinatal Community Advisory Boards at both hospitals. These boards, unique in New Jersey, comprise people who have given birth at the institutions, community leaders, social service providers, community health workers, and others.
The goal of the boards, known as PCABs, is to build community trust and ensure that health systems hear the experiences of people who gave or will give birth at their hospitals. Acting as a bridge between the hospital and the community, the board helps inform hospital policies and services to create sustainable change.
“Many people in local communities have lived experiences and expertise that can be valuable to hospitals seeking to continually improve the quality of the care they provide,” said Adelisa Perez-Hudgins, MSN, RN, Director of Quality at the Quality Institute. “The Perinatal Community Advisory Boards are an innovative way for hospitals to engage their communities around maternal child health.”
Alexandra Nelson, Service Line Director, Maternal and Child Services at Capital Health, called the PCAB valuable.
“Hearing from, and being responsive to, our patients and community is a vital part of being a community focused healthcare provider,” Nelson said. “Having the opportunity to hear directly from those who have used, or plan to use, our services gives us the chance to hear what we are doing right, but even more importantly, what we can improve or consider as we develop our services.”
The PCABs met recently for the first time.
Charissa Lene, a member of the PCAB at Capital Health Medical Center – Hopewell, said she recently learned more about the issues surrounding Black maternal health through her breastfeeding support group after the birth of her son.
“I joined the Board because I want to bring awareness to maternal health,” she said. “I want to be an advocate and a voice for others in the community. I want to help make sure parents are aware of everything available to them, like resources, services, and mental health support.”
Another PCAB member, at Penn Medicine Princeton Medical Center, shared how PCABs and the overall Raising the Bar initiative will impact the community. “Care you receive can feel like it’s happening to you, rather than involving you,” said Karina, a new mom. “This initiative will help capture the blind spots in care and improve outcomes and communication. So many positives can come from this.”
Another part of the Quality Institute’s Raising the Bar pilot with the two hospitals is Maternal Health Benchmarking, a comprehensive review of each hospital’s maternal infant health services, maternal child outcomes, and experiences of people giving birth. The benchmarking explores services such as lactation support, mental and behavioral health resources, midwifery and doula care, social supports — and other areas such as available language support and quality improvement initiatives.
The Maternal Health Benchmarking data from the two hospitals was collected through information provided by the hospitals, individual and group interviews with leadership, staff, and patients, and publicly available information. Results from the benchmarking effort were shared back with the hospitals, and the hospitals will receive guidance from the Quality Institute as they work toward improving birth equity and creating change.
The Raising the Bar pilot also asks hospitals to create a shared decision-making model of care. Both hospitals will implement TeamBirth, a model currently used by thirteen hospitals and two birth centers in New Jersey. Funding for TeamBirth in New Jersey is largely provided through a Health Resources and Services Administration (HRSA) grant from the New Jersey Department of Health. The TeamBirth model of care uses structured huddles with the full care team, including the person giving birth, and other tools to promote the birthing person’s active involvement in health care decisions. The approach moves away from the traditional medical hierarchy in health care settings.
The Quality Institute leads TeamBirth in New Jersey in partnership with Ariadne Labs.
“The New Jersey Health Care Quality Institute has been a tremendous partner in our work to make New Jersey the safest and most equitable state in the nation to deliver and raise a baby,” said First Lady Tammy Murphy. “I am excited that Capital Health and Penn Medicine Princeton Health will be participating in this innovative pilot which will help raise community voices through Perinatal Community Advisory Boards, benchmark progress in achieving improved outcomes, and implement a shared decision-making model of care. A key element of our efforts to improve outcomes for moms and babies has always been to work hand-in-hand with our community partners, so this initiative will be critical in collecting crucial information to benefit families across our state.”
Christine Ivery, MPH, CHES, Program Officer at the Quality Institute, applauded the two hospitals for joining the Raising the Bar NJ initiative to advance maternal child health in their own facilities while also piloting strategies that could be incorporated elsewhere to impact the nation’s maternal health crisis.
“The leadership at both hospitals stepped forward to strengthen the care their hospitals provide,” Ivery said. “We applaud their efforts to work more closely with communities than ever before and to work with us to advance ways to improve outcomes and experiences of people giving birth.”
About the New Jersey Health Care Quality Institute
At the New Jersey Health Care Quality Institute our mission is to improve the safety, quality, and affordability of health care for everyone. Our vision is to create a world where all people receive safe, equitable, and affordable health care and live their healthiest lives.