Neonatal Transport Data:An Opportunity for

Quality Improvement

A product of:California Perinatal Transport System (CPeTS)

Managed by: California Perinatal Quality Care Collaborative (CPQCC)

Continuing Education CreditContinuing Education Credit

After reviewing the materials in the Neonatal After reviewing the materials in the Neonatal Transport Data System File and viewing Transport Data System File and viewing the presentation, go to the following link to the presentation, go to the following link to complete the post-test and evaluation. complete the post-test and evaluation.

http://www.surveymonkey.com/s.asp?http://www.surveymonkey.com/s.asp?u=815383080691u=815383080691

ObjectivesUnderstand the new Neonatal Transport Data System;Understand the new Neonatal Transport Data System;Demonstrate ability to correctly obtain and report data Demonstrate ability to correctly obtain and report data elements using agreed upon data definitions and elements using agreed upon data definitions and procedures;procedures;Demonstrate ability to complete on-line reporting of Demonstrate ability to complete on-line reporting of required data elements;required data elements;List 3 resources for assistance in completing data List 3 resources for assistance in completing data collection; andcollection; andIdentify available reports that can be utilized among Identify available reports that can be utilized among transport partners as part of Regional Cooperation transport partners as part of Regional Cooperation Agreements, Joint Mortality and Morbidity Conferences Agreements, Joint Mortality and Morbidity Conferences and to identify education, consultation and policy needs.and to identify education, consultation and policy needs.

Toward Improving the Outcome of Pregnancy II

System For Regionalized Perinatal Care System For Regionalized Perinatal Care

““the development, within a geographic area, of a the development, within a geographic area, of a coordinated, cooperative system of maternal and coordinated, cooperative system of maternal and

perinatal perinatal health care in which, by mutual agreements health care in which, by mutual agreements between hospitals and physicians and based on between hospitals and physicians and based on

population needs, the degree of complexity of maternal population needs, the degree of complexity of maternal and perinatal care each hospital is capable of providing and perinatal care each hospital is capable of providing is identified so as to accomplish the following objectives: is identified so as to accomplish the following objectives:

quality care to all pregnant women and newborns, quality care to all pregnant women and newborns, maximal utilization of highly trained perinatal personnel maximal utilization of highly trained perinatal personnel

and intensive care facilities, and assurance of and intensive care facilities, and assurance of reasonable cost effectiveness”. reasonable cost effectiveness”.

March of Dimes, Birth Defects Foundation, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, 1994.

California Perinatal Transport System (CPeTS)

CPeTS was established by California Assembly CPeTS was established by California Assembly Bill 4439, in 1976. Bill 4439, in 1976. to facilitate transports of critically ill infants and to facilitate transports of critically ill infants and

mothers with high risk conditions to Neonatal mothers with high risk conditions to Neonatal Intensive Care Units (NICUs) and Perinatal High Risk Intensive Care Units (NICUs) and Perinatal High Risk Units. Units.

to collect and analyze perinatal and neonatal to collect and analyze perinatal and neonatal transport data for regional planning, outreach program transport data for regional planning, outreach program development, and outcome analysis. development, and outcome analysis.

CPeTS has engaged the California Quality Care CPeTS has engaged the California Quality Care Collaborative (CPQCC) to manage the data Collaborative (CPQCC) to manage the data system. system.

Key Transport Issues IdentifiedKey Transport Issues Identified

These issues included:These issues included:Perceived underutilization of maternal transport; Perceived underutilization of maternal transport; Perceived delay in decision to transport infant;Perceived delay in decision to transport infant;Difficulty in obtaining transport placement/ Difficulty in obtaining transport placement/ acceptance;acceptance;Delay in effecting transport following decision; and Delay in effecting transport following decision; and Consistent referring facility competency regarding Consistent referring facility competency regarding infant stabilization prior to the transport team’s infant stabilization prior to the transport team’s arrival, as well as transport team competency. arrival, as well as transport team competency.

Title 22 - Hospital Licensing§70547 Perinatal Care Units§70547 Perinatal Care Units

(a4) Formal arrangements for consultation and/ or transfer (a4) Formal arrangements for consultation and/ or transfer of an infant to an intensive care newborn nursery, or a of an infant to an intensive care newborn nursery, or a mother to a hospital with the necessary services for mother to a hospital with the necessary services for problems beyond the capability of the perinatal unit.problems beyond the capability of the perinatal unit. (b) There shall be written policies and procedures (b) There shall be written policies and procedures developed and maintained by the person responsible for developed and maintained by the person responsible for the service in consultation with other appropriate health the service in consultation with other appropriate health professionals and administration. These policies and professionals and administration. These policies and procedures shall reflect the standards and procedures shall reflect the standards and recommendations of the American College of recommendations of the American College of Obstetricians and Gynecologists…and the American Obstetricians and Gynecologists…and the American Academy of Pediatrics…Academy of Pediatrics…

California Code of Regulations, Title 22: Social Security, Volume 28, Revised California Code of Regulations, Title 22: Social Security, Volume 28, Revised November, 1995. Perinatal Unit General RequirementsNovember, 1995. Perinatal Unit General Requirements

AAP/ACOG Guidelines for Perinatal Care

Recommends the following minimal regional evaluation of perinatal Recommends the following minimal regional evaluation of perinatal transport programs: transport programs:

Patient Outcome DataPatient Outcome Data Unexpected neonatal morbidity (eg, hypothermia or tension pneumothorax) Unexpected neonatal morbidity (eg, hypothermia or tension pneumothorax) Mortality during transport Mortality during transport Morbidity or mortality of patients at the receiving hospital.Morbidity or mortality of patients at the receiving hospital.

Logistic Information Logistic Information Frequency of failure to transfer patients generally considered to require Frequency of failure to transfer patients generally considered to require

tertiary care (eg, newborns born at < 32 weeks of gestation), tertiary care (eg, newborns born at < 32 weeks of gestation), Availability of all the services that may be needed by the perinatal patient, Availability of all the services that may be needed by the perinatal patient, Accessibility of services, Accessibility of services, Capability to connect the patient quickly and appropriately with the services Capability to connect the patient quickly and appropriately with the services

needed, and needed, and Programs to promote patient and community awareness of available and Programs to promote patient and community awareness of available and

appropriate regional referral programs. appropriate regional referral programs.

AAP/ACOG Guidelines for Perinatal Care, Fifth Edition, 2002AAP/ACOG Guidelines for Perinatal Care, Fifth Edition, 2002

California Children’s Services (CCS)

§3.25.1-30 Infant morbidity and mortality data concerning birthweight, survival, transfer, incidence of certain conditions and other information as required shall be submitted to the Chief, Childrens Medical Services Branch/CCS Program annually. 4.A.(4) Maintenance of written records of each neonatal transport completed shall be available for review by CCS program staff.4B….All guidelines and reporting requirements of the Regional Perinatal Dispatch Center shall be followed.

California Children’s Services (CCS) Manual of Procedures, Chapter 3 – California Children’s Services (CCS) Manual of Procedures, Chapter 3 – Provider Standards, Section 3.25 Standards for Neonatal Intensive Care Units Provider Standards, Section 3.25 Standards for Neonatal Intensive Care Units (NICUs), State of California, Department of Health Services, California Medical (NICUs), State of California, Department of Health Services, California Medical Services, January 1, 1999.Services, January 1, 1999.

PolicyA Neonatal Transport Form must be A Neonatal Transport Form must be completed for all neonates acutely completed for all neonates acutely transferred to or from a CCS-designated transferred to or from a CCS-designated NICU, as well as all facilities participating NICU, as well as all facilities participating in CPQCC. in CPQCC.

Selected data elements will be Selected data elements will be electronically reported via the CPQCC electronically reported via the CPQCC

Transport Activity Report Transport Activity Report

MaterialsMaterialsAll California Neonatal Transport Form (ACNTF)All California Neonatal Transport Form (ACNTF)Core CPeTS Neonatal Transport Form (CCNTF)Core CPeTS Neonatal Transport Form (CCNTF)Color-coded All California Neonatal Transport FormColor-coded All California Neonatal Transport FormPolicy and Procedure Policy and Procedure 2007 Data Definitions and Training Manual2007 Data Definitions and Training ManualSample ReportsSample ReportsEducational PresentationEducational PresentationArticlesArticles

Transport risk index of physiologic stability (TRIPS): A practical system for assessing infant transport care by Lee, S.K., et al. (J

Peds, Vol. 139, No. 2, 220-226, August, 2001) The Mortality Index for Neonatal Transportation Score: A New

Mortality Prediction Model for Retrieved Neonates by Broughton, S.J. et al. (Pediatrics, Vol. 114, No. 4, 424-428, April 20, 2004)

Data Collection ResponsibilityData Collection ResponsibilityCompleting a neonatal transport record is the Completing a neonatal transport record is the joint responsibility of the referring and receiving hospital.joint responsibility of the referring and receiving hospital.

Data elements to be completed by the referring Data elements to be completed by the referring hospital are shown in 10% gray scale.hospital are shown in 10% gray scale.Data to be completed by the transport team or Data to be completed by the transport team or receiving facility are shown in 15% gray scale on the receiving facility are shown in 15% gray scale on the actual form.actual form.Information collected for continuity of care should be Information collected for continuity of care should be completed by members of both the referring and completed by members of both the referring and receiving hospitals in order to ensure safe and receiving hospitals in order to ensure safe and effective transfer of care.effective transfer of care.Sections that pertain to quality improvement issues Sections that pertain to quality improvement issues can be completed by staff from either facility. This can be completed by staff from either facility. This page should be separated prior to placing the form page should be separated prior to placing the form into the patient record. The separated section is then into the patient record. The separated section is then handled following internal hospital policies for QI handled following internal hospital policies for QI data.data.

Referring HospitalReferring HospitalInitiate form when a neonate is identified as a potential candidate for acute transport to another facility. Information requested in the following sections should be obtained prior to calling the receiving hospital. This information is necessary in order to assess patient stability, potential complications and to co-manage care prior to transfer of care.

Referral Information Patient Identification/History Infant Condition Modified TRIPS Score

Provide to the receiving hospital at the time of the referring call. Completing the form prior to the call and faxing this information to the receiving facility will help to ensure safe and effective hand off of patients between providers.

Data CollectionData Collection

Patient condition should be the driving force in Patient condition should be the driving force in timing of transport initiation. timing of transport initiation.

Delay in referral to collect data should be avoided.Delay in referral to collect data should be avoided.

If specific information is not available at the initial If specific information is not available at the initial call it can be transmitted by telephone or fax to call it can be transmitted by telephone or fax to the transport team or receiving hospital prior to the transport team or receiving hospital prior to

departure for the referring facility. departure for the referring facility.

Referral: Information required at initial contact between referring and receiving center/providers to facilitate transport.

T.1 Transport type DR Attendance Requested ASAP Neonatal Scheduled Neonatal Other ________________

T.2 Indication Medical Dx/Rx Services Growth/Discharge Planning Surgery Chronic Care Insurance

T.3 Date/Time(D/T) Referral: @ T.4 Acceptance @

T.5 Maternal Admission to Labor & Delivery/Hospital Date/Time @

Patient Identification/History: Information to be obtained prior to transport.

Infant’s Name___________________ Singleton Multiple __of __ T.6 Birth D/T _________ @______Ins. ___________

T.7 Birth wt. __ __ __ __ gms Current wt. __ __ __ __ gms T.8 Gestational Age __ __wks__ days T.9 M F Unk

T.10 Prenatally Diagnosed Congenital Anomalies Y N Unk Describe

Mother’s Name Birth Date Age __ __ yrs MedRec#

T.11 G __ P AB L ROM Date/Time @ Duration __ __ hrs Fluid Clear Meconium

Antenatal Conditions None Unk Hypertension Diabetes Infection Preterm Labor Bleeding/Abrupt/Previa Other: _____________

Significant Antepartum/Intrapartum Issues: Delivery Spont. Vag Op. Vag Vacuum Forceps Cesarean Primary Repeat

Apgar ScoresScore N/D Unk1 __ __ 5 __ __ 10__ __ 15__ __ ______________________

Antibiotics Y Specify__________ N Unk

T.12 Steroids Y N (last dose) @

T.13 Surfactant Given Y N Unk DR NSY NICU(first dose) @

Modified TRIPS ScoresModified TRIPS Scores

The modified The modified Transport Risk Index of Transport Risk Index of Physiologic Stability (TRIPS) ScorePhysiologic Stability (TRIPS) Score contained in contained in the Infant Condition Section will provide uniform the Infant Condition Section will provide uniform assess of patient status and stabilityassess of patient status and stabilityObtained three times:Obtained three times: Within 15 minutes of the time of referral by referring Within 15 minutes of the time of referral by referring

hospital staffhospital staff Within 15 minutes of transport team arrival at referring Within 15 minutes of transport team arrival at referring

facility by transport teamfacility by transport team Within 15 minutes of team return to receiving NICU by Within 15 minutes of team return to receiving NICU by

receiving hospital staffreceiving hospital staff

Critical Components of the Modified Critical Components of the Modified TRIPS ScoreTRIPS Score

ResponsivenessResponsiveness

Respiratory StatusRespiratory Status Oxygen Index completed if patient is on Oxygen Index completed if patient is on

mechanical ventilation onlymechanical ventilation only

Vital SignsVital Signs

Blood GlucoseBlood Glucose

Blood Gases (if obtained) and type of Blood Gases (if obtained) and type of respiratory support providedrespiratory support provided

Modified TRIPS Score: to be recorded on referral, within 15 minutes of arrival at referring hospital and admit to NICU.

Referrala

Initial TT Eval b

NICU Admit c

T.14 Time (24 hour)

T.15 Responsiveness

Respiratory T.16 Rate

T.17 O2 Saturation

T.18 Status

Oxygen Index*T.19

MAP

FiO2

PAO2

Vital Signs T.20 HR

T.21 BP Sys/ Dia, Mean

T.22 Pressors Y N YN Y N

T.23 Temp. C°

T.24 Blood Glucose

Bld. Gas T.25 Resp. Support

pH

PCO2

BE

Responsiveness: 0=Death 1=None, Seizure, Muscle Relaxant 2=Lethargic, no cry 3=Vigorously withdraws, cry. Resp Support: None, Hood/NC. NCPAP, ETT Respiratory Status: 1=Respirator 2= Severe (apnea, gasping, intubated but not on respirator) 3=Other * Oxygen Index completed if pt. is on vent.

Referring HospitalReferring Hospital

The following sections should be completed The following sections should be completed prior to transport with the most current data prior to transport with the most current data available.available.

Clinical InformationClinical InformationOther Significant IssuesOther Significant IssuesReferral ProcessReferral ProcessInformation / Materials Sent with Transport Information / Materials Sent with Transport Team and Care ProvidersTeam and Care Providers..

Additional comments, documentation of Additional comments, documentation of procedures, patient response to procedures procedures, patient response to procedures and other significant information can be and other significant information can be recorded in the recorded in the CommentsComments section at any section at any point in the transport process. point in the transport process.

Clinical Information

Date Time Results

Hgb/HCT @

Bld. Cult. @

Bilirubin @

Screening: Hearing Y N Unk Metabolic Y N Unk

Subs Exp Y N Ukn

Imaging: CXR @

Other (specify)

IV Access/Fluids (type, rate, site)

Bld. Trans. @ (type,vol)

Last Urine @ Stool @

Feeding (type/rt/vol) First Last

Meds given within last 24° Eye care Vit. K

Date/Time Med Dose Rt.

Allergies Y type N Unk

Surgery Y N Indication NEC CHD Other

DeathNo Yes @ Prior to team arrival Prior to departure Prior to arrival at NICU**

Transport Team/Receiving HospitalTransport Team/Receiving Hospital

Transport team/Receiving hospital staff should review Transport team/Receiving hospital staff should review all information in the following sections. all information in the following sections.

Referral InformationReferral Information Patient Identification/HistoryPatient Identification/History

Infant Condition Modified TRIPS ScoreInfant Condition Modified TRIPS Score (referral) (referral) sections. Upon return to receiving NICU (within 15 sections. Upon return to receiving NICU (within 15 minutes of arrival) the third and final (NICU admit) minutes of arrival) the third and final (NICU admit) Infant Condition Modified TRIPS ScoreInfant Condition Modified TRIPS Score section section should be completed. should be completed. Infant Condition Modified Infant Condition Modified TRIPS ScoreTRIPS Score (referral) (referral) sections. sections.

On arrival at the referring hospital, the transport team On arrival at the referring hospital, the transport team members are responsible for assigning the second members are responsible for assigning the second Infant Infant Condition Modified TRIPS ScoreCondition Modified TRIPS Score section within 15 section within 15 minutes of arrival (Initial Transport Team).minutes of arrival (Initial Transport Team).

Modified TRIPS Score: to be recorded on referral, within 15 minutes of arrival at referring hospital and admit to NICU.

Referrala

Initial TT Eval b

NICU Admit c

T.14 Time (24 hour)

T.15 Responsiveness

Respiratory T.16 Rate

T.17 O2 Saturation

T.18 Status

Oxygen Index*T.19

MAP

FiO2

PAO2

Vital Signs T.20 HR

T.21 BP Sys/ Dia, Mean

T.22 Pressors Y N YN Y N

T.23 Temp. C°

T.24 Blood Glucose

Bld. Gas T.25 Resp. Support

pH

PCO2

BE

Responsiveness: 0=Death 1=None, Seizure, Muscle Relaxant 2=Lethargic, no cry 3=Vigorously withdraws, cry. Resp Support: None, Hood/NC. NCPAP, ETT Respiratory Status: 1=Respirator 2= Severe (apnea, gasping, intubated but not on respirator) 3=Other * Oxygen Index completed if pt. is on vent.

Transport Team/Transport Team/Receiving HospitalReceiving Hospital

The following sections should be completed prior to The following sections should be completed prior to transport with the most current data available in transport with the most current data available in consultation with staff from the referring facility. consultation with staff from the referring facility.

Clinical InformationClinical InformationOther Significant IssuesOther Significant IssuesReferral ProcessReferral ProcessTimelineTimelineInformation / Materials Sent with Transport Team and Information / Materials Sent with Transport Team and Care ProvidersCare Providers

Additional comments, documentation of procedures, Additional comments, documentation of procedures, patient response to procedures and other significant patient response to procedures and other significant information can be recorded in the information can be recorded in the CommentsComments section section at any point in the transport process. at any point in the transport process.

Clinical Information

Date Time Results

Hgb/HCT @

Bld. Cult. @

Bilirubin @

Screening: Hearing Y N Unk Metabolic Y N Unk

Subs Exp Y N Ukn

Imaging: CXR @

Other (specify)

IV Access/Fluids (type, rate, site)

Bld. Trans. @ (type,vol)

Last Urine @ Stool @

Feeding (type/rt/vol) First Last

Meds given within last 24° Eye care Vit. K

Date/Time Med Dose Rt.

Allergies Y type N Unk

Surgery Y N Indication NEC CHD Other

DeathNo Yes @ Prior to team arrival Prior to departure Prior to arrival at NICU**

Referral Process

T.26 Referring Hospital Name

Code Telephone Number

Referring OB

Referring Peds

Informant

T.27 Previously Transported? Y N From: Hospital Name Code

T.28 Birth Hospital (if not listed above) Hospital Name Code

Receiving Hospital Accepting Physician

T.29 Trans. Team On-Site Leader Sub-specialist MD Peds Other MD/Resident NNP Transport Spec. Nurse Present prior to transport team arrival Y N @

T.30 Team From Receiving Hospital Contract Service (CPQCC TT ID ) Referring Hosp.

T.31 Mode Ground Helicopter Fixed Wing Indication Transport Carrier

Timeline

Date Time Comments

T.32 Transport Team Departure for Referring Hospital @

T.33 Transport Team Arrival at Referring Hospital @

Transport Team Departure from Referring Hospital @

Transport Team Arrival at Receiving Facility @

Information/Materials To Be Sent With Transport Team (check all provided)

Chart (pt. record) Maternal Neonatal Blood Specimen Maternal Neonatal Placenta Imagining copies

Other, specify

Care Providers name /title signature D/T of arrival

Referring Hospital @

@

Transport Team @

@

@

@

Confidential Neonatal Transport Confidential Neonatal Transport Improvement PotentialImprovement Potential

Information gathered at any point during the resuscitation, Information gathered at any point during the resuscitation, stabilization, referral, and transport process regarding stabilization, referral, and transport process regarding quality improvement issues, may be recorded in the quality improvement issues, may be recorded in the Confidential NeonatalConfidential Neonatal Transport Issues with Transport Issues with Improvement Potential Improvement Potential Form. Form.

Form should be separated from the first two pages of the Form should be separated from the first two pages of the form prior to placing the form into the patient record. The form prior to placing the form into the patient record. The separated section is then handled following internal separated section is then handled following internal hospital policies for QI data.hospital policies for QI data.

Issues identified should reviewed jointly by referring and receiving Issues identified should reviewed jointly by referring and receiving hospitals staff at Mortality and Morbidity Reviews, annual review of hospitals staff at Mortality and Morbidity Reviews, annual review of Regional Cooperation Agreement or other appropriate QI venue. Regional Cooperation Agreement or other appropriate QI venue.

These issues may also be used to identify joint policy and These issues may also be used to identify joint policy and procedure requirements, educational opportunities and or gaps in procedure requirements, educational opportunities and or gaps in services that should be referred to team responsible for annual services that should be referred to team responsible for annual review and negotiation of the Memorandum of Understanding review and negotiation of the Memorandum of Understanding (MOU).(MOU).

Transport Issues with Improvement Potential (Quality Improvement Data)

Delay in transport, describe: ______________________________________________Related to Amb./vehicle issues Traffic Missed opportunity for maternal transport Delay in transferring infant

Transport Team Difficulties, describe: _______________________________________ Required elements of elements form incomplete, describe: _____________

Equipment Difficulties, describe: __________________________________________

Unplanned Intervention During Transport, describe: ____________________________

Related to Airway Vascular Access Return to Referring Hospital Other _______________________________CPR during transport

Death prior to admission to receiving NICU**

None

Other, describe

Comments

Referred for Joint Mortality/Morbidity Review Y N Unk Date of Review

Outcome of Review: Policy/Procedure Change Joint QI Project Education Offering Consultation

Other: describe

Follow up:

On-line Reporting of DataOn-line Reporting of Data

Selected data elements (found in Red Selected data elements (found in Red highlighted, highlighted, BOLDBOLD on the sample and NTR on the sample and NTR forms) will be electronically reported via the forms) will be electronically reported via the CPQCC Transport Activity Report. CPQCC Transport Activity Report.

This reporting should take place following the This reporting should take place following the transport but prior to submitting routine transport but prior to submitting routine Admission/Discharge Data to the CPQCC. All Admission/Discharge Data to the CPQCC. All transported patients are eligible for inclusion in transported patients are eligible for inclusion in the CPQCC dataset. the CPQCC dataset.

Data DefinitionsData Definitions

Data definitions and directions for Data definitions and directions for completing each item on the NTR can completing each item on the NTR can be found in the attached be found in the attached 2007 Manual 2007 Manual of Definitions – Neonatal Transport of Definitions – Neonatal Transport Data Collection Tools. Data Collection Tools.

RECEIVING HOSPITAL REPORT

Acute Transport Activity

Infants 1,500 grams or less born between 01/01/2006 and 12/31/2006

 

Center Same CCS Level within CPQCC

Center-Network Comparison

(N=141) (N Centers=94 )

N % Last Year's% % Median% Lower Quartile

% Upper Quartile

Acute Transport Type

 

Dr Attendance Requested

43   30.5   30.6   25   19   30  

ASAP Neonatal

71   50.4   50.6   41 35 50

Scheduled Neonatal

27   19.1   17.6   32 24 39

  Other 0   0   1.2   0   0   2  

Birth Weight

For a finer birth weight breakdown, click here.

 750 grams or less

28   19.9   19.4   24   16   28  

751-1,000 grams

35   24.8   24.1   21 15 27  

 1,001-1,500 grams

78   55.3   56.5   55   47   65  

Gestational Age

For a finer gestational age breakdown, click here.

 under 25 weeks

19   13.5   13.5   16   11   20  

25 to 27 weeks

43   30.5   35.3   27 20 33  

28 to 30 weeks

56   39.7   32.4   36 30 40

31 to 33 weeks

21   14.9   17.1   16 13 23

34 to 37 weeks

2   1.4   1.8   2 0 5

 38 to 41 weeks

0   0   0   0   0   0  

 

 

 

Thank You!Thank You!

Neonatal Transport Data Work Group

Allen Fischer, MD

Philippe S. Friedlich, MD

Balaji Govindaswami, MD, MPH

Andrew Hopper, MD

Robert Kahle, MD

Frank L. Mannino, M.D.

Gil Martin, MD

Rod Phibbs, MD

Francis Poulain, MD

Bob Roth, MD

Terri Slagle, MD

Leslie Williams

Data Collection Advisory Committee

Jeanetter Asselin

Grace Villarin Duenas

Co-ChairsCo-ChairsJeffrey Gould, MD, MPH Jeffrey Gould, MD, MPH Al Hackel, MDAl Hackel, MD

StaffStaffD. Lisa Bollman, RNC, MSN D. Lisa Bollman, RNC, MSN Barbara Murphy, RN, MSN Barbara Murphy, RN, MSN Grace Villarin DuenasDani KernsKatherine CrossBeate DanielsenPemita Pa’aga

Fulani Irving

Key Informants &Focus Group ParticipantsNorthern CaliforniaNorthern California

Jackie BagattaJackie BagattaLaura BerritoLaura BerritoAlice BlackAlice BlackMichelle CordovaMichelle CordovaRobin CourtneyRobin CourtneyJo DannerJo DannerLouise FryLouise FryAl HackelAl HackelAllan FischerAllan FischerAllan FishmanAllan FishmanMary LynchMary LynchBarbara Mochizuki Barbara Mochizuki Barbara MurphyBarbara MurphyLois OwenLois OwenRod PhibbsRod PhibbsRichard PowersRichard PowersGloria SantosGloria SantosPamela StanleyPamela StanleyWendi StoverWendi StoverJill ThorntonJill ThorntonChrista ThomasChrista ThomasLori SaundersLori SaundersChristine WilliamsChristine WilliamsLeslie WilliamsLeslie WilliamsBarbara WernerBarbara Werner

Southern CaliforniaSouthern CaliforniaD. Lisa BollmanD. Lisa BollmanUday DevaskarUday DevaskarVijay DharVijay DharRalph E. FranceschiniRalph E. FranceschiniPhillippe S. FriedlichPhillippe S. FriedlichMary GoldbergMary GoldbergBalaji GovindaswamiBalaji GovindaswamiJeff GouldJeff GouldAl HackelAl HackelSudeep KukrejaSudeep KukrejaFrank ManninoFrank ManninoSally McGannSally McGannAndy MossaAndy MossaBarbara MurphyBarbara MurphyMark SpezialeMark SpezialeArthur StraussArthur StraussSophia TseSophia TseCherry UyCherry UyUlrika Walfridsson-SchultzUlrika Walfridsson-SchultzDavid WirtschafterDavid Wirtschafter

Beta Test FacilitiesBeta Test Facilities

California Medical CenterCalifornia Medical CenterChildren’s Hospital of Central CaliforniaChildren’s Hospital of Central CaliforniaChildren’s Hospital & Research Center at OaklandChildren’s Hospital & Research Center at OaklandLucille Packard Children Hospital at StanfordLucille Packard Children Hospital at StanfordPresbyterian Intercommunity Medical CenterPresbyterian Intercommunity Medical CenterSanta Clara Valley Medical CenterSanta Clara Valley Medical CenterSt. Francis Medical CenterSt. Francis Medical CenterSt. Mary Medical CenterSt. Mary Medical CenterSutter Memorial Hospital, SacramentoSutter Memorial Hospital, SacramentoUniversity of California, Davis Medical CenterUniversity of California, Davis Medical CenterUniversity of California, San FranciscoUniversity of California, San Francisco

Special thanks to the following groups for their input review and advice:

CPQCCExecutive CommitteePerinatal Quality Improvement CommitteeData Collection Advisory GroupData Center Staff

CPeTS:Executive CommitteeNorthern California Perinatal Quality Improvement CommitteeSouthern California Perinatal Quality Improvement Committee

Regional Perinatal Programs of California

California Department of Health Services, Maternal, Child and Adolescent Health Branch/Office of Family Planning and

Childrens Medical Services (CMS); California Childrens Services (CCS)