Successful maternal mortality review committees (MMRC) are composed of diverse members from multidisciplinary backgrounds. While MMRC members contribute their expertise during the review process, there are other roles that are essential to the functioning and sustainability of the review.

Case abstractors are the most critical members of maternal mortality review committees (MMRC). Case abstraction is the most time-consuming process in administering an MMR and requires an extensive amount of training and resources. MMRCs should have one or more clinically trained case abstractors, preferably nurses with five or more years of experience in obstetric care. Abstractors must be persistent and detail-oriented when collecting and managing data.

MMRC case abstractors should have a standing position on the committee rather than a rotating role. Jurisdictions decide how to fill this position in a way that best maximizes resources and case load. For example, in larger jurisdictions, case abstractors might be staff members from regional perinatal centers. In smaller jurisdictions, the same case abstractor working with Fetal and Infant Mortality Review (FIMR) may also abstract maternal death cases.

Committee chairs are responsible for providing overall leadership to the committee. Responsibilities may include the following:

  • Developing structured agendas for case review meetings
  • Facilitating case discussions
  • Ensuring minimal personal biases
  • Ensuring data-driven recommendations
  • Serving as committee representative at conferences and stakeholder meetings
  • Engaging the participation of each group member

MMRCs need support positions as well. These positions should include a coordinator, a database manager, and one or more epidemiologists. Their responsibilities can vary between individual reviews. For example, coordinators might take on some of the facilitation and agenda-setting responsibilities for review committee meetings. They may meet with case abstractors to prioritize cases and review the status of a case sent for abstraction. Coordinators also ensure key committee documents, such as the policies and procedures, are updated and implemented. In addition, they may be responsible for disseminating findings from review deliberations.

Database managers can help by ensuring that the data strategy of the MMRC adheres to the jurisdiction’s data management policies. Epidemiologists may provide data analysis support for developing products from the reviews, such as fact sheets and reports. In most cases, these individuals are not exclusively dedicated to the review but assist the review among their other job duties.


MMRIA Committee Facilitation Guide

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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.

Abstraction and Case Review Time Cost Estimator

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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.