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Regional Perinatal System (RPS)
>> California Perinatal Quality Care Collaborative (CPQCC)
The California Perinatal
Quality Care Collaborative (CPQCC) is an outgrowth of an initiative
proposed by the California Association of Neonatologists and supported
by the David and Lucile Packard Foundation and the State of California
Department of Health Services, Maternal and Child Health Branch.
CPQCC was formed in 1997 and brings together a public-private alliance
of stakeholders in the care and outcomes of California's mothers
and babies. The collaboration exists to improve the health of pregnant
women, infants, and children by collecting high-quality information
on perinatal outcomes and resource utilization which then allows
for performance improvement and benchmarking processes in perinatal
care and neonatal intensive care units throughout California.
The CPQCC Collaborative Network
Over the past several years, CPQCC has been very successful
in developing a network of stakeholders interested in improving
perinatal health care in California. The CPQCC network consists
of public and private obstetric and neonatal providers, health care
purchasers, public health professionals and private sector health
industry specialists. More specifically, these collaborators include:
- California Association of Neonatologists (CAN)
- American College of Obstetricians and Gynecologists (ACOG)
- California Maternal and Child Health Branch (MCH)
- California Children's Services (CCS)
- California Office of Vital Records (OVR)
- Office of Statewide Health Planning and Development (OSHDP)
- Regional Perinatal Programs of California (RPPC)
- Health Insurance Plan of California
- Pacific Business Group on Health
- David and Lucile Packard Foundation
- The Vermont Oxford Network
- UC Berkeley School of Public Health
- Stanford University's Center for Health Policy and Research
(HRP)
The CPQCC Data Center
CPQCC has partnered with the Vermont Oxford Network (VON) and
Stanford University's Center for Health Policy and Research (HRP)
to collect and analyze perinatal health data used for developing
and monitoring perinatal quality health improvement projects initiated
by CPQCC. Much progress has been made in the development of CPQCC's
data center. A web-based reporting format has been developed over
the last year, which allows hospitals to view multiple outcomes
and interventions broken down by various categories, such as, birth
weight, gestational age, inborn or outborn status, etc. A menu also
enables hospitals to view tables and figures by subgroup.
The CPQCC Data Center currently supports two major projects:
- These distinguished collaborators serve as the CPQCC Executive
Committee which meets regularly to debate, review, prioritize,
and plan perinatal quality improvement initiatives.
The Vermont Oxford Network - a database enrolling VLBW infants
admitted to NICUs worldwide, with 370 member centers and a ten
year cohort of clinical data.
- The CPQCC Selected Big Babies Database - an expanded database
enrolling infants with birthweights over 1500 grams who meet specific
clinical eligibility criteria, with 60+ member centers in California.
Information generated from these databases, provides CPQCC member
hospitals with valuable information that can be used to compare
themselves against other unidentified participating hospitals.
In 2000, CPQCC collaborated with Children's Medical Services Branch
in producing the CCS reports for 19 CCS hospitals with NICUs. In
2001, CPQCC and CCS finalized the reporting format outlining eligibility
requirements for member hospital participation, supplemental information
required from participating hospitals, report submission procedures
and details for program follow-up and evaluation. Due to the success
of the CCS/CPQCC joint reporting program, CPQCC began recruiting
hospitals for collection of 2001 data. Twenty-four NICUs participated
in the joint CCS/CPQCC reporting project. However, it is expected
that there will be a significant increase the number of NICUs participating
in the near future, since CCS is now mandating that all CCS-approved
hospitals submit annual morbidity and mortality data through participation
in CPQCC beginning in January 2004.
The Perinatal Quality Improvement Panel (PQIP)
The Perinatal Quality Improvement Panel (PQIP) is a permanent subcommittee
of stakeholders with expertise in the area of quality improvement.
Through its efforts, CPQCC is building an effective quality improvement
infrastructure at the state, regional, and individual hospital levels.
PQIP is responsible for analyzing CPQCC data and reviewing the literature
for evidence based best practices in perinatal care. Based on its
findings, PQIP defines indicators and benchmarks, recommends quality
improvement objectives, provides models for performance improvement,
and assists providers in a multi-step transformation of data into
improved patient care.
CPQCC Toolkits are one of the quality improvement interventions
that have been developed by PQIP. CPQCC Toolkits are designed to
promote successful quality improvement activities at the hospital
level, based on hospital-specific data. To date, CPQCC has developed
a series of toolkits, each focusing on key topics related to perinatal
care. These toolkits provide valuable information on the following
practices:
- Nosocomial Infection Prevention
- Antenatal Corticosteroid Therapy
- Postnatal Steroid Administration
- Reducing Chronic Lung Disease
CPQCC Toolkits can be downloaded from the CPQCC
website at http://www.cpqcc.org
Additionally, CPQCC offers workshops throughout California where
teams of practitioners from member hospitals can work together to
develop improvement aims, select processes to improve, develop methods
to overcome barriers, and prepare personal action plans.
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