First Year Cleveland

First Year Cleveland

Case Western Reserve University School of Medicine
Biomedical Research Building
11000 Cedar Avenue - 4th Floor Cleveland, OH 44106

Phone 216-368-4837
Home About Us FYC Action Teams Addressing Extreme Prematurity

FYC Action Teams

Priority Area: Addressing Extreme Prematurity

(Learn more about what we're doing in this priority area)

GOAL: By the end of 2020, the 2015 preterm birth rate of 14.9 percent will be reduced to less than 10 percent by the end of 2020 (14.9 percent represents City of Cleveland, March of Dimes data).

RESULTS TO DATE: The county's overall preterm birth rate was 14.9 percent in 2015, and 11.37 percent in 2020.*

Action Team 4: Collect data and establish Learning Circles to identify and resolve issues contributing to extreme premature births and infant deaths.

GOAL: Prevent or delay extreme premature births and optimize outcomes for peri-viable births (less than 26 weeks gestational age). 

Recent Accomplishments:  FYC Action Team 4 (led by Better Health Partnership) brought together four health systems who normally compete to achieve a shared goal. The team spearheaded data collection efforts to assess modifiable interventions related to prenatal care, the delivery of the baby and the NICU stay. The team then analyzed and prioritized findings through monthly learning circles and determined quality improvement interventions. These findings were communicated to the larger health systems, FYC, Better Health Partnership membership and national OB/GYN providers, who then began implementation of quality improvement interventions. 

QI interventions across health systems currently underway include: 

  • Improving reliability and consistency with ultrasounds/cervical length screenings for early assessment of premature birth risk. 
  • Improving care coordination and connection to prenatal care for pregnant women who visit Emergency Rooms. 
  • Improving early establishment of gestational age, pregnancy viability, and determination of pregnancy risk. 
  • Recommending protocols to EMS to transport pregnant women to emergency rooms where labor and delivery services are available in the hospital. 
  • Each health system is conducting diversity, equity, inclusion training and education to improve the patient experience and reduce racial bias in care delivery. 
  • These interventions are undergoing continuous improvement. 

Action Team 5: Educate expectant parents and improve access to treatments to help prevent premature birth and ensure healthy pregnancies.

GOAL:  Partner with Maternal and Child Health (MCH) and social service providers to identify opportunities for enhanced service delivery and engagement with MCH population. Engage Cuyahoga County families in the development and implementation of community-driven strategies to improve birth outcomes for women at highest risk for infant death. Educate and engage families to improve maternal and child health outcomes through the provision of evidence based programs and interventions such as but not limited to CenteringPregnancy, 17P, and reproductive health services.

Recent Accomplishments:  FYC Action Team 5 (led by Cuyahoga-Cleveland Ohio Equity Institute) coordinated advocacy efforts to support equitable access to pregnancy-related services in Emergency Rooms in the county’s southeast quadrant and created a palm card to educate families on where to seek emergency room services. This team also conducted Home Visiting Training, held a resource fair for expectant and new parents, and connected more than 700 pregnant women to supportive services. 

FYC Action Team 5 also worked with the Greater Cleveland Regional Transit Authority to pilot a program aimed at reducing infant mortality rates by providing free rides to new and expectant mothers. The “Baby on Board” program provides free monthly bus passes to eligible pregnant women and new moms living In ZIP codes with very high rates of infant mortality because transportation is often cited as a primary reason for missing medical appointments. 

Action Team 6: Increase public awareness of LARC and birth spacing guidelines.

GOAL: Work with providers to increase public awareness of birth spacing guidelines, implement One Key Question, and improve access to long-acting reversible contraception (LARC). 

Recent Accomplishments: FYC Action Team 6 (led by the Center for Community Solutions and March of Dimes) was formed to work with healthcare providers to increase public awareness of birth spacing guidelines, implement One Key Question (OKQ), and improve access to long-acting reversible contraceptives. The OKQ pilot with home visitors in the Parents as Teachers (PAT) program (Cuyahoga County Bright Beginnings) was completed in November, with the final booster training of the home visitors. The booster revisited the OKQ intervention and provided additional support for conversations on contraception, identified by the cohort as a need. The intervention is ongoing with the PAT program, and data is being collected on when the question is asked, the responses, and related referrals. 

Action Team 7: CenteringPregnancy® Model.

GOAL: Increase the number of expectant moms being served through a CenteringPregnancy® model. 

Recent Accomplishments:  FYC Action Team 7 (led by Cuyahoga County CenteringPregnancy® Coalition) leads the CenteringPregnancy® program effort, with programming provided by University Hospitals, Cleveland Clinic, The MetroHealth System, Care Alliance Health Center, and Northeast Ohio Neighborhood Health Services. An enrollment goal of 1,881 pregnant and postpartum women was established for the period Jan. 1, 2020 through Dec. 31, 2021. In 2020, CenteringPregnancy® programs enrolled 408 pregnant and postpartum women, achieving about 22% of their overall goal, with in-person group sessions significantly impacted for all providers by COVID-19. Ongoing attempts at virtual only group sessions were not well received over the timespan of a pregnancy, with the initial engagement wearing off over time. With a resurgence in OB visits in October 2020, the program began to see an increase in the numbers enrolling in group prenatal care and has since resumed in-person sessions. National data show that Black expectant parents served in a CenteringPregnancy® program experience a 41% reduction in premature births. 

Action Team 8: Address social determinants of health.

GOAL: Address social determinants impacting expectant parents by serving over 4,000 pregnant mothers annually in results-driven interventions that address housing insecurity, employment, education, nutritional needs and early access to prenatal care and post care. 

Recent Accomplishments:  FYC Action Team 8 (led by Invest in Children, Bright Beginnings, ODH and ODM) coordinated services for more than 3,000 pregnant women and caregivers with new babies annually in results-driven interventions that address housing insecurity, employment, education, nutrition, and early access to prenatal and postnatal care. 

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