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    Perinatal Quality Collaboratives (PQCs)

    What Are PQCs? Why Are PQCs Important?


    PQCs are networks of clinical teams, public
    health leaders, and other stakeholders and PQCs are a platform for collaborative learning.
    partners, including patients and families, PQCs develop relationships across multiple stakeholders including
    that work together to improve pregnancy hospitals, community health centers, state health departments, patients,
    and infant outcomes. Members of PQCs insurers, and nonprofit organizations. They provide a framework to
    identify health care processes that need implement best practices and address emergent issues affecting
    improvement within their state, then use maternal and neonatal health.
    the best available methods to affect change
    as quickly as possible. PQCs are critical for PQCs are positioned to make changes quickly.
    rapid dissemination of best practices and PQCs work to cultivate health care facility “buy-in,” in multiple ways,
    implementation of effective initiatives to including engaging key clinical leads and organizational partners across
    improve outcomes for pregnant women and the state. This helps PQCs to mobilize hospitals to adopt best practices in
    newborns. clinical care quickly. Members of PQCs apply a community of change
    model shown to be successful for rapid dissemination of evidence-based
    Nearly every state has a PQC or one in approaches.
    development. CDC has supported
    state-based PQCs since 2011 and currently PQCs make population-based improvements.
    funds 27 state-based PQCs in Alaska, PQCs aim to improve care across a population, not just within one
    Arkansas, California, Colorado, Florida, facility. PQCs can identify a specific outcome to improve, support
    Georgia, Illinois, Indiana, Louisiana, large-scale systematic quality improvement efforts across facilities, and
    Massachusetts, Maryland, Maine, Michigan, compare the performance of health care facilities within the state.
    Mississippi, Montana, North Dakota, (and
    South Dakota as participating state),
    Nebraska, New Jersey, New York, Ohio,
    PQCs closely monitor health care facility progress.
    After identifying an area for change, PQCs provide rapid data collection
    Tennessee, Texas, Utah, Virginia,
    and feedback to clinical teams. This enables them to track their progress
    Washington, Wisconsin, and West Virginia.
    in meeting the objectives for the project and adapt interventions to
    improve success.

    What Have PQCs Accomplished?


    States and health care facilities participating in PQC quality improvement
    efforts have made population health improvements. These accomplishments
    address important issues affecting maternal and infant health, including:
    Reductions in elective deliveries without a medical indication before
    39 weeks gestation.
    Reductions in unnecessary cesarean births among low-risk pregnant
    women.
    Reductions in health care-associated bloodstream infections in
    newborns.
    Reductions in severe maternal morbidity from hemorrhage and
    hypertension.
    Reductions in preterm births.
    Improvements in breastfeeding rates.
    How Does CDC Support PQCs?
    In addition to directly funding 27 PQCs, CDC supports the National
    Network of Perinatal Quality Collaboratives (NNPQC) to help PQCs
    nationwide make measurable improvements. Since 2017, the National
    Institute for Children’s Health Quality (NICHQ) has coordinated the
    NNPQC and provides a forum for all PQCs to share experience and
    knowledge that includes webinars, an online community network, and
    in-person meetings.

    What Is the Future of PQCs?


    PQCs can adapt and address critical current and emergent perinatal health issues facing our nation.

    CDC will continue to support strong science that demonstrates the impact of using a collaborative population-based
    approach to improve the quality of care for our nation’s moms and babies.

    As state maternal mortality review committees (MMRCs) develop clinical recommendations to improve maternal
    outcomes, PQCs will be a key partner to facilitate the implementation of recommendations more broadly across health
    facility networks.

    How Does CDC’s PQC Program Collaborate with Other Federal Agencies?
    CDC collaborates with state and federal partners to improve maternal and neonatal
    outcomes. For example, the Health Resources and Services Administration manages the
    Alliance for Innovation on Maternal Health (AIM), a program focused on reducing
    maternal deaths and morbidity by implementing evidence-based safety bundles, best
    practices for improving safety in maternity care. PQCs are the quality improvement
    infrastructure that supports the dissemination and implementation of the AIM bundles.

    State PQC Highlight: A Story From the Field


    To address rising maternal deaths associated with preeclampsia, the Illinois PQC (ILPQC) conducted a project to improve care for
    pregnant and postpartum women with severe preeclampsia (including women with preexisting hypertension) and eclampsia in 112
    Illinois hospitals. The number of women receiving medication within 60 minutes increased from 42% to 85% during the project, and the
    rate of severe pregnancy complications among pregnant women experiencing hypertension at delivery in Illinois decreased by 41%
    during this initiative. This project is now in a sustainability phase, which includes hospital planning support from ILPQC, continued
    monthly review and reporting of data in the ILPQC data system, and quarterly team webinars.

    Learn More
    • CDC PQC Website:
    www.cdc.gov/reproductivehealth/maternalinfanthealth/pqc.htm
    • National Network of Perinatal Quality Collaboratives:
    www.nichq.org/project/national-network-perinatal-quality-collaboratives
    • AIM States and Systems:
    https://safehealthcareforeverywoman.org/aim-states-systems-2/

    Centers for Disease Control


    and Prevention
    National Center for Chronic Disease
    Prevention and Health Promotion

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