The quality of a case review and deliberations about individual deaths directly align to the expertise and commitment to the mission of the review by committee members serving on the MMRC. Committees should have a chair to provide overall leadership and vision for the group, members to inform the case review, and support from abstractors, coordinators, epidemiologists, and database managers.
In some states, the legislation that authorizes the MMRC outlines the process through which committee members can be identified and appointed. The authorizing legislation may specify disciplines that must serve on the committee, or more specifically, may mandate that representatives of organizations serve on the committee (e.g. the state Medicaid agency, hospital leadership). For states that have flexibility in the appointment of committee members, individuals responsible for establishing the MMRC may use an array of tactics to identify potential committee members, such as an open call for nominations or direct invitation to key stakeholder groups.
There is no recommended number of members serving on the MMRC. The total number of MMRC members is contingent upon the scope of the review (e.g. whether or not the review includes injury-related deaths), the number of deaths reviewed by the committee, and the committee’s mission (e.g. to advance health equity). Collectively, the members of an MMRC should be able to examine the clinical, social, and environmental factors that led to a maternal death. A diverse review committee comprised of members who represent a variety of clinical and psychosocial specializations, members working in different areas of the respective state, representatives of rural and urban or different race/ethnic backgrounds in that state, and disciplines such as social workers and community organizations can enhance the depth of reviews. MMRCs must balance breadth of expertise with the ability to reach consensus during case reviews.
A recommended membership strategy is to identify and recruit members who have skills across more than one role and can wear multiple hats on the committee. This flexibility can serve a great need because all members may not be able to participate in every meeting. Additionally, the frequency of meetings will depend on the purpose, scope, and case load of a review committee.
|Organizations||Core Disciplines||Specialty Disciplines|
|Behavioral Health Agencies||Family Medicine||Clergy|
|Blood Banks||Forensic Pathology||Community Leadership|
|Community Advocate||Maternal Fetal Medicine/ Perinatology||Critical Care Medicine|
|Community Birth Workers||Nurse Midwifery||Nutrition|
|Federal Qualified Health Centers||Obstetrics and Gynecology||Emergency Response|
|FIMR/CDR Programs||Patient Safety||Epidemiology|
|Healthy Start Agencies||Perinatal Nursing||Genetics|
|Homeless Services||Psychiatry||Home Nursing|
|Hospitals/ Hospital Associations||Public Health||Law Enforcement|
|Private and Public Insurers||Social Work||Mental Health Provider|
|Professional Assoc. State Chapters||Pharmacy|
|Rural Health Associations||Public Health Nursing|
|State Medical Society||Quality/Risk Management|
|State Medicaid Agency||Addiction Counseling|
|State Title V Program|
|State Title X Programs|
|Violence Prevention Agencies|
Maintaining a comprehensive MMRC is essential to influence maternal outcomes. To retain members, MMRC leaders can implement the following strategies:
Some states may also invite key stakeholders to assist with reviews and serve on a review temporarily. To vet stakeholders or replacement members, MMRC leaders can implement the following strategies: