Alliance for Innovation on Maternal Health (AIM)

The goal of implementing AIM safety bundles is to improve the clinical structures and processes of care and improve patient outcomes for pregnant and postpartum Vermonters with substance use disorders. This is done with standardized, actionable steps that have been proven to reliably improve patient care. 

• Reduce the severe maternal morbidity associated with preventable obstetric hemorrhages (Rollout: 2020)
• Improve recognition and timeliness of treatment in hypertensive emergencies in pregnancy (Rollout: Fall 2022)
• Screen and identify pregnant or recently pregnant persons with cardiac conditions and appropriately refer (Rollout: TBD)
• Provide universal screenings, referral support, and education to pregnant or postpartum people with substance use disorder in a trauma-informed way (Rollout: Early 2025)

• 11 Vermont hospitals are enrolled in AIM projects [100%]
• 2 safety bundles implemented
• Included Family Medicine, Anesthesia, and Emergency Department colleagues in drills and education

In 2024, the following strategies and resource materials were utilized to ensure the sustainability of our implemented bundles:

• We redesigned our OB Drill binder and pared it down to make it even more accessible and easy to use for our Providers and Staff on the inpatient obstetric and postpartum units.
• Running in-situ drills and facilitating debriefs is a skill that needs to be practiced and developed. We created and host 4-hour workshops to support interested Staff RNs and Providers in the basics of running drills, how to facilitate a pre-brief, and make the most out of debriefing sessions. We utilize the OB tackleboxes as our main resource.
• One of the greatest challenges noted by our participating hospitals is the collaboration between the Obstetrics unit and the Emergency department. Many of the AIM bundles reference this collaboration especially in the recognition of pregnant or recently pregnant patients. One strategy we implemented was highlighting the most important elements in a checklist and then partnered with a guide of examples. This work was newly implemented in 2024 and is on-going in it’s use.

Tackling OB Drills - In Situ Drill Tacklebox  

• We redesigned our OB Drill binder and pared it down to make it even more accessible and easy to use for our Providers and Staff on the inpatient obstetric and postpartum units. 
• All the essentials are found in the tacklebox including three hypertension and three hemorrhage scenarios. We will use the structure created with these tackleboxes to add scenarios as we implement new bundles. Upcoming scenarios will include cardiac emergency, trauma-informed patient interaction, and working with patients with substance use disorder.  

OB Drill Facilitator Workshop  

• Running in-situ drills and facilitating debriefs is a skill that needs to be practiced and developed. We created and host 4-hour workshops to support interested Staff RNs and Providers in the basics of running drills, how to facilitate a pre-brief, and make the most out of debriefing sessions. We utilize the OB tackleboxes as our main resource. 
• This workshop includes 2-2.5hrs of presentation content and then 1.5-2hrs of practice simulation. Attendees can pilot these new skills by performing the different roles and receiving feedback from the instructors and their peers.  

Escape Room   

We are aiming to give Staff multiple ways to learn and engage in this content. We’ve created a few escape room adventures that do not require a facilitator to run.