Fall CHoSEN Forum Hosted Virtually on October 13th

With the coronavirus (COVID-19) pandemic ongoing, multidisciplinary professionals from across the Rocky Mountain region who support families impacted by prenatal substance exposure convened virtually on October 13th to share updates and learn from each other’s successes and challenges in implementing related quality improvement efforts. 

• Dr. Susan Hwang shared updates on the CHoSEN Collaborative’s hospital-level efforts, including the most recent data on average lengths of inpatient stays for opioid-exposed newborns, percentages of opioid-exposed newborns who received pharmacologic therapy, and impacts that the COVID-19 pandemic may have had on these indicators most recently. During her update, Dr. Hwang also reflected on the data published in the Maternal Mortality Review Committee Report earlier this year, which indicates that suicide and drug overdose were the leading causes of pregnancy-associated maternal deaths in Colorado between 2014-2016. Lastly, Dr. Hwang shared the exciting news of CHoSEN’s first publication of a paper in Hospital Pediatrics regarding how the collaborative’s quality improvement efforts have led to shortened lengths of stay and a reduction in the use of pharmacological treatments to care for substance-exposed newborns. 
• CPCQC’s Jaime Cabrera shared updates on new funding streams that will make it possible to place more of a focus on care for the birthing individual, and Illuminate Colorado’s Jade Woodard shared policy and systems level updates, including:
  • Information on the recent revision to the Children’s Code that modifies the definition of abuse and neglect as the result of prenatal substance exposure
  • New efforts to increase access to child care for parents and caregivers navigating complex life situations, like mental health concerns, substance use disorders, or employment challenges, and
  • The Toxicology Resource Guide, which provides guidance on toxicology implications as they relate to child welfare. 

• The keynote presentations focused on a variety of challenges and opportunities related to the improvement of care for substance-exposed newborns. Dr. Hafastou Diop presented on the opportunities related to early intervention enrollment of infants with NAS, such as improving post-discharge care, supporting the parent-child relationship, and connecting parents with OUD to other support services. She also reflected on the variety of parental, hospital, and provider factors that present challenges to early intervention enrollment and shared ideas on approaches to addressing them. Dr. Munish Gupta presented on the many improvements that perinatal quality collaboratives have helped to make to care of substance-exposed newborns and reflected on the opportunities they have to contribute to even more improvements, such as increasing treatment for pregnant individuals with OUD, improving post-discharge care of both the birthing individual and newborn, and identifying and working to address barriers for families of color. 

• Participating CHoSEN hospitals shared updates on their work on each of CHoSEN Collaborative’s key drivers, and Presbyterian St. Luke’s Medical Center shared their experience participating in the Colorado pilot for the Alliance for Innovations on Maternal Health (AIM) Opioid Use Disorder Bundle. 
• Attendees learned how they can improve their care of families straight from the experts, as individuals with lived experience related to substance use and pregnancy shared their overall experiences and their specific experiences related to bias and stigma, ways they were encouraged and discouraged from accessing care, and ways in which they did or did not receive patient-centered care. Due to the sensitivity of the topics and in order to respect the privacy of the speakers, this session was not recorded.
• At the end of the day, attendees participated in small group breakout discussions on the implementation of the AIM Opioid Use Disorder Bundle, Family Engagement, Non-Pharmacological Approaches, and Working with Child Welfare and Plans of Safe Care and shared their takeaways with the full group.

Missed the event or looking to refresh your memory of the day? Find the materials, recordings, and related upcoming opportunities to engage linked below.

Materials and Recordings:

• Slides from the day can be found here.
• Recordings of the main sessions can be found here.
• For more information on maternal deaths in Colorado from 2014-2016, see the Maternal Mortality Review Committee Report and find CHoSEN’s first published paper here. 

The work continues! While our world continues to look different, the CHoSEN Collaborative team is still here to support your efforts and connect you to related initiatives. 

Opportunities to Engage: 

• If you are looking for support with your hospital's quality improvement efforts, including virtual site visits, please reach out to Susan Hwang. 
• To learn more about the upcoming implementation of the AIM Opioid Use Disorder Bundle in Colorado, reach out to Katie Breen or Valerie Garrison. 
• To get involved in policy advocacy and other systems-level work that impacts substance- exposed newborns and their families, please contact Jillian Adams Fabricius.