WASHINGTON, DC (December 3, 2024)—In response to findings from the Illinois Maternal Mortality Review Committees (MMRCs), which revealed that the majority of those who died while pregnant or within one year postpartum visited the emergency department (ED), the MMRCs recommended strengthening ED provider education to better address maternal health in Illinois. A new study, featured as the Editor’s Choice for the November/December Women’s Health Issues, introduces the Maternal Health Emergency Department Toolkit — a comprehensive educational package designed to help Illinois ED providers and staff deliver high-quality, timely care to pregnant and postpartum patients — and reports findings from the development process evaluation.
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based at the Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
Katherine A. Craemer and Dr. Stacie Geller, of the University of Illinois Chicago Center for Research on Women and Gender in the College of Medicine, and their co-authors led an interdisciplinary Task Force that produced the Toolkit. This study outlines the development process for creating the Toolkit, the Toolkit content, and the feedback received from the Task Force that led its development.
Organized by topics identified by the Illinois MMRCs, Task Force members collaborated in five work groups where they identified existing resources and developed novel content. The Toolkit includes five educational modules with best practices, guidelines, and case scenarios specifically tailored to improve responses to maternal health care in the ED. These include: A) Introduction to Maternal Mortality: How Emergency Departments Can Help; B) Acuity Assessment and Management of Perinatal Emergencies; C) Screening for Perinatal Mental Health and Behavioral Health Issues; D) Trauma and Resuscitation in Pregnancy; and E) Best Practices for Pregnant and Postpartum Patients being Discharged from the Emergency Department. The modules also include essential resources developed by the Task Force, including a Perinatal Triage Algorithm, a Discharge Flow Chart to Determine Follow-up Time, and an ED Discharge Resource Packet for pregnant and postpartum patients.
After the Toolkit’s development, the authors administered a survey and conducted a verbal listening session with Task Force members to collect their feedback about what facilitated and hindered their work, as well as recommendations they would make to other organizations that aim to develop similar products. Task Force members advised involving a range of experts with interdisciplinary knowledge, especially ED experts; holding regularly scheduled virtual meetings; breaking into work groups; grounding the content in local maternal health data; and developing a clear idea of the final product and a timeline.
“The Maternal Health Emergency Department Toolkit can improve maternal health outcomes in Illinois because it fills the gaps in educational materials for the ED and is rooted in the Illinois MMRCs’ findings and recommendations,” Craemer and her colleagues write. “Other states can improve their maternal health outcomes by providing support to their EDs and requiring maternal health education like the Toolkit.” The modules have been piloted at six hospitals where they were established as evidence-based and are being prepared for public distribution. Funded by the Illinois Department of Public Health, the Toolkit is being implemented at all emergency departments in Illinois.
“This Toolkit is the kind of output we hoped to see when states began creating maternal mortality review committees,” said Karen McDonnell, Editor-in-Chief of Women's Health Issues and associate professor of prevention and community health at Milken Institute SPH. “It’s a resource to help close some of the gaps review committee analyses identified, and it has the potential to improve maternal health in Illinois and beyond.”
“Development of a Maternal Health Toolkit for Emergency Department Education in Illinois” has been published in the November/December 2024 issue of Women’s Health Issues.