Transcript Sedgwick County Fetal and Infant Mortality Review Project

The FIMR Project
Shalae Harris, RN, BSN, MPA
FIMR Coordinator/Chart Abstractor
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Healthy Babies
Sedgwick County Health Department
Central Plains Regional Health Care Foundation
Kansas Department of Health and Environment
 Bureau of Health Informatics
 Bureau of Local and Rural Health
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SIDS Network of Kansas
Medical Society of Sedgwick County
KUMC– Wichita, Office of Research
Kansas City Healthy Start
 Mahatma
Gandhi said, “a nation’s
greatness is measured by how it treats
its weakest members”.
 Our
littlest members are key indicators
of a community’s well being
 Infant
health is a measure of
community well-being. (NFIMR
website, 2001)
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Death of a child under one year of age
Infant death is measured by the infant mortality
rate
Infant mortality rate (IMR) is the number of deaths
for babies under one year of age in a given year for
every 1,000 live births in the same year
The IMR is measured in every country and US state
Source: Heath, United States, 2009
Japan
2.6
2.8
Sweden
Spain
3.8
France
3.8
Germany
3.8
Australia
4.7
England and Wales
5.0
United States
6.7
0
Source: Heath, United States, 2009
1
2
3
4
5
6
Rate per 1,000 live births
7
Source: Bureau of Epidemiology and Public Health Informatics, KDHE; National Center for Health Statistics, CDC
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Kansas ranks 29th in the nation (2007)
Kansas’ rate was 17% higher than US rate
(2007)
Kansas ranks #1 in the nation for black infant
mortality (2007)
Infant Mortality Rate (per 1,000 live births)
25.0
20.0
15.0
10.0
5.0
0.0
IMR for Sedgwick County (African
American)
IMR for Sedgwick County (all races)
IMR for Kansas (all races)
IMR for U.S. (all races)
2000-2002 2001-2003 2002-2004 2003-2005 2004-2006 2005-2007 2006-2008 2007-2009
17.5
17.8
17.3
19.2
19.6
21.6
18.0
18.8
9.0
7.1
6.9
8.6
7.1
6.9
8.0
7.0
6.9
7.8
7.1
6.8
8.2
7.3
6.8
8.7
7.5
6.8
7.7
7.5
6.7
8.1
7.4
6.5
The Causes of Infant Mortality
Physical
Social/Environmental
 Low birth weight
 Disparities in health care
access
 Prematurity
 Birth Defects
 Disparities in living
conditions
 SIDS
 Relational issues
 Stress
 Environmental conditions
6%
23%
28%
15%
11% 17%
Source: Bureau of Epidemiology and Public Health Informatics, KDHE
Birth Defects (Congenital Anomalies)
SIDS
Short gest./low birth weight
Maternal preg. complications
Other
External causes of mortality
FIMR
Fetal Infant Mortality
Review
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A collaborative effort of community, county, state,
and federal resources to reduce the IMR
An action oriented process that continually
assesses, monitors, and works to improve
community resources and service delivery systems
The FIMR project is designed to enhance the
health and well being of women, infants, and
families by improving the community
resources and service delivery systems
available to them.
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About fault finding or assigning blame for
death of the infant
A comprehensive quality assurance program
for hospitals or clinics
About conducting original research on the
causes of infant death
The FIMR Process
 Data Gathering
 Reviews de-identified cases
 Identifies interventions to address factors that were
associated with the infant death
 Implements community based interventions and/or
policies for change
 Assesses the progress of these interventions and their
long term impact on reducing infant mortality
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Notification of death
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Case records abstraction
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Maternal/Family interview
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Case summary
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Changes in community systems
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Reviews case data from medical records and family
interviews
Identifies trends and gaps in services
Makes recommendations to the CAT for systemic
community change
21 members met July 2010-June 2011
 Representing over 20 organizations
 22 cases reviewed
 25 Cases with attempted interviews
 10 Cases with completed interviews
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2010 recommendations surround 3 themes:
◦ Education
◦ Connection
◦ Access
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Develops community interventions based on
recommendations received
Utilizes existing community resources to
implement intervention strategies
Addresses the need for resources and services not
currently available
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CAT core team is 15 members
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Past year met 6 times
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Representing 6 organizations
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2 task forces focusing on FIMR CRT education
recommendations:
◦ Maternal Tobacco Cessation CAT Task Force
◦ AHBBY CAT Task Force
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Infant health is a measure of community well-being.
FIMR is a community coalition.
FIMR programs engage a diverse membership.
FIMR programs thrive on effective group process.
Action is key to FIMR.
FIMR programs take on a wide range of community action.
FIMR programs build on existing community assets.
The FIMR process is a journey, not a destination.
FIMR programs use population based data.
FIMR programs communicate to the larger community.
FIMR programs recognize and celebrate the work of their team
members.
NFIMR, National Fetal Infant Mortality Review, ACOG website
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Educate
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Bring Awareness
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Support
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Document
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Dr. Dennis Cooley, Chairperson, Kansas Blue Ribbon Panel on Infant Mortality
“Kansas Infant Mortality” PowerPoint, September 2, 2010.
Dr. Diane Helentjaris, Virginia Department of Health, “The Silent Epidemic:
Uniting to Reduce Infant Mortality” PowerPoint, September 2, 2010.
Kansas Department of Health and Environment, Bureau of Family Health,
Bureau of Public Health Informatics.
Kansas Department of Health and Environment, Center for Health Disparities
Kansas Blue Ribbon Panel on Infant Mortality ,Infant Mortality Factsheet and
FIMR concept paper.
TFIMR, Tulsa Fetal & Infant Mortality Review Project, “An Introduction for
Prospective Members of the Case Review Team (CRT), PowerPoint, 1998.
NFIMR, National Fetal Infant Mortality Review, ACOG website
Shalae Harris, RN, BSN, MPA
FIMR Coordinator/Chart Abstractor
Sedgwick County Health Department
Healthy Babies
434 N. Oliver, Suite 110
Wichita, KS 67208
316-660-0984
[email protected]