​The Maryland Perinatal-Neonatal Quality Collaborative

Since 2003, the Maryland Perinatal Neonatal Quality Collaborative (PNQC), a statewide network of birthing hospitals, perinatal providers, public health professionals have worked together to make Maryland the safest place to have a baby. Through continuous quality improvement, the Collaborative works to improve outcomes for newborns and pregnant individuals.

To learn more about the Maryland Perinatal-Neonatal Quality Collaborative, please visit: https://www.mdpqc.org

Timeline of the Maryland Perinatal-Neonatal Quality Collaborative

2003Maryland Department of Health start the Maryland Perinatal Neonatal Quality Collaborative (PNQC)
2006Maryland Patient Safety Center (PSC) begins overseeing the PNQC with funding from the then Department of Health and Mental Hygiene.
2007PNQNC provides education in its initial change package which included:
  1. Improving teamwork and communication through TeamSTEPPSⓇ education
  2. Obstetric emergency drills education
  3. Safe use of Pitocin
2009Grant received from CareFirst Blue Cross Blue Shield to improve neonatal adverse outcomes index with focus on interventions during “Golden Hour” (i.e,. first hour of life) for infants with birth weight less than 1500 grams.
  • Initiative results in statistically significant decrease in neonatal adverse outcomes index (p-value=0.033) during a follow up period from 2007-2010.
2009Began “Reduce Early Elective Deliveries” at < 39 weeks gestational age without medical indications Quality Initiative
  • Collaborative ends in December 2013 with a 94% reduction in rate of early C-section deliveries in 2009 (10.4% to 0.6%) and 95% reduction in early elective inductions (2% to 0.2%)
  • Maryland becomes first state to have all birthing hospitals recognized by March of Dimes to reduce Early Elective Deliveries to less than 5%
2014Multidisciplinary clinical and public health experts are added to the Maryland PNQC steering committee.
2014-2018The Maryland PNQC continues to grow.
  • Participation in the Maryland PNQC regional listserv more than doubles from 320 to over 700 participants.
2015Maryland PSC becomes the second state designated as a member of the Alliance for Innovation in Maternal Health (AIM), a Health Resources and Services Administration (HRSA) supported program. This program provides technical assistance to implement nationally-endorsed patient safety bundles designed to reduce maternal mortality and severe maternal morbidity.
2016-2018Maryland launches “Safely Reduce Primary Cesarean Sections” using a complex AIM bundle becoming the first state to do so.
  • Percentage of first-time low-risk (i.e. nulliparous, term, singleton, vertex) cesarean deliveries are reduced from 30.1% to 27.8% to participating hospitals in two years.
  • Results in 470 cesarean sections avoided with a cost reduction of $898,701.
  • Total reduction of NTSV cesarean deliveries and in those following labor reduction by 2nd quarter of 2019 were 7.6% and 13%, respectively.
  • Results from this collaborative were presented at several scientific and profession meetings and published in the journal, Obstetrics and Gynecology
Maryland launches “Neonatal Abstinence Syndrome (NAS): Improving Care to Improve Outcomes” was launched to standardize best practices for infants with NAS.
  • Length of stay (LOS) in the Neonatal ICU was decreased by 3 days in infants diagnosed with NAS with a cost savings of $1.8 million.
  • Transfers out of the birth hospital for infants diagnosed with NAS decreased by 56% (from 16.8% to 7.4%) at the end of the collaborative.
  • Maryland named “State of E​ducation Excellence” by the Vermont Oxford Network as 85% of participating hospitals achieved collaborative goals
2019 “Obstetric Care of Women with Opioid Use Disorder (OUD)” and “Safe Infant Sleep” collaboratives were launched to reduce drug overdoses in pregnant women (the leading cause of maternal mortality in Maryland).
2020Undergoing the competitive bid process, the Maryland Department of Health awards Health Quality Innovator as the new vendor to coordinate the Maryland PNQC.
The Maryland PNQC launches “Severe Hypertension in Pregnancy Bundle” and “Neonatal Antibiotic Stewardship" to improve maternal and child health in Maryland.