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MMRC Authorities and Protections Checklist

Year of publication or last update: 
2017

Efforts to establish or strengthen a maternal mortality review committee (MMRC) should include a review of what protections and authorities are already in place. This document shows key components to consider and sample legislative language for each component.

Considerations for Hiring Abstractors

Year of publication or last update: 
2017

Abstractors play a key role in Maternal Mortality Review Committees. Their expertise and skills are closely tied to the quality of information that is presented to the committee and ultimately to the accuracy of identified issues and recommendations for improvement. It is important for abstractors to have a basic understanding of the significance of changes in vital signs, reported symptoms, and cascading events, as well as documentation of the escalation of care measures to develop a comprehensive case narrative. In addition to the technical skills and knowledge required for the task of abstraction, abstractors must have strong interpersonal skills to acquire records from the field.

MMRIA MMRC Abstractor Manual

Year of publication or last update: 
2017

This manual is an in-depth guide to case abstraction, intended for abstractors both seasoned and new to their positions.

MMRC Logic Model

Year of publication or last update: 
2017

Although MMRCs differ from state to state, the logic model is designed to represent the general inputs, activities, and outcomes of an ideal, fully functional MMRC. The logic model can serve as a starting point, and is adaptable to the context of individual state or city-based MMRCs.

In this logic model, the Outputs and Short-term Outcomes columns are joined by the condition: “MMRC recommendations are part of a cycle of continuous quality improvement for health systems.” This is a necessary condition for MMRCs to span the gap between Process and Outcomes.

Abstraction and Case Review Time Cost Estimator

Year of publication or last update: 
2017

Refer to the abstractor time estimates spreadsheet for assistance in calculating the number of hours of abstraction required for your committee each year.

Note: in addition to abstractors, MMRCs often require the equivalent of one full-time position divided between three people: a half-time coordinator, a quarter-time data analyst, and a quarter-time clerk. This will vary, however, by the number of cases that the committee reviews.

Report from MMRCs: A View into Their Critical Role

Year of publication or last update: 
2017

What is this report?

A preliminary report of data from four states using an innovative data-collection system provides the first in-depth look at key factors contributing to maternal death and showcases opportunities for prevention.

For example:

  • It offers concrete evidence that a maternal death is the tragic result of an intersection of a number of factors. It is the sum of a range of circumstances related to communities, healthcare facilities, providers, and patients. On average, three to four critical factors were identified for each pregnancy-related death.
  • This report highlights that causes of pregnancy-related death differ by age and depending on whether a woman was pregnant, was in delivery or had recently delivered.
  • These data also show that mental health conditions were a leading cause of pregnancy-related death in these four states. More specifically, among postpartum women, suicide most commonly occurs in the late-postpartum period.
  • As more states participate, we can use these data to identify causes and contributing factors to pregnancy-related death and the prevention opportunities with the greatest potential impacts.

Guidance for Using the MMRIA Committee Decisions Form

Year of publication or last update: 
2018

The following webinar was recorded on March 23, 2018 to assist committees in using the MMRIA Committee Decisions form and to answer frequently asked questions: https://ondieh.adobeconnect.com/put5ctfi87qj/. The accompanying slide set and PMSS-MM Underlying Cause of Death Decision Tree are discussed in the webinar recording. The PMSS-MM Underlying Cause of Death Decision Tree may be particularly helpful when reviewing deaths related to suicide and substance overdoses.

Motion Graphic: Consensus, Decision, and Next Steps

Year of publication or last update: 
2018

Committees must answer a series of questions to complete the Committee Decisions form. Watch the video below to gain more insight into how a committee reaches consensus on these important points.

Pregnancy-Associated Deaths Brief Case Review

Year of publication or last update: 
2017

Many committee members find it beneficial to hear a brief overview of the process for identifying and selecting cases for abstraction and review. Such an overview fosters engagement of committee members in the entire maternal mortality review process and offers a system of checks and balances to the case identification and selection process.

Items to consider for this discussion may include the process used for identification, a summary of cases identified and the process for sending cases for abstraction.

MMRIA Committee Facilitation Guide

Year of publication or last update: 
2017

This guide is intended to share best practices that will help maternal mortality review committees (MMRCs) establish processes for case review. The guide is structured in the general order of steps a committee might take in conducting an actual review committee meeting. Your committee may choose to do things differently depending on your resources, committee makeup, and scope. Consider this document a tool to help you establish a strong foundation for committee facilitation from which to develop and build upon your own skills and experience.