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PA PQC SUD Survey (January through March 2022)
Please work with your team to complete this birth site-level survey for the designated quarter, starting with January through March 2022.
*
1.
What is your PA PQC Hospital or Affiliation?
(Required.)
ACMH Hospital
AHN – Forbes Hospital
AHN – Jefferson Hospital
AHN – Saint Vincent Hospital
AHN – West Penn Hospital
AHN - Wexford
Commonwealth Health – Moses Taylor Hospital
Conemaugh Memorial Medical Center
Crozer-Keystone Health System - Crozer-Chester Medical Center
Crozer-Keystone Health System - Delaware County Memorial Hospital
Doylestown Hospital
Einstein Medical Center Montgomery
Einstein Medical Center Philadelphia
Evangelical Community Hospital
Excela Health - Greensburg Community Hospital
Geisinger – Bloomsburg Hospital
Geisinger – Lewistown Hospital
Geisinger - Community Medical Center
Geisinger – Medical Center, Danville
Geisinger – Wyoming Valley Hospital
Guthrie – Robert Packer Hospital Birthing Center
Holy Redeemer Hospital
Jefferson Health – Abington Hospital
Jefferson Health – Thomas Jefferson University Hospital
Lehigh Valley Health Network – Cedar Crest
Lehigh Valley Health Network – Muhlenberg
Lehigh Valley Health Network – Pocono
Lehigh Valley Health Network - Schuylkill
Main Line Health - Bryn Mawr Hospital
Main Line Health - Lankenau Medical Center
Main Line Health - Paoli Hospital
Main Line Health - Riddle Hospital
Mount Nittany Health System - Mount Nittany Medical Center
Penn Medicine – Chester County Hospital
Penn Medicine – Hospital of the University of Pennsylvania
Penn Medicine – Lancaster General/Women and Babies
Penn Medicine – Pennsylvania Hospital
Penn State Health - Holy Spirit Medical Center
Penn State Health - Milton S. Hershey Medical Center and Children’s Hospital
Punxsutawney Area Hospital
St. Clair Hospital
St. Luke’s University Health Network – Allentown
St. Luke’s University Health Network – Bethlehem
St. Luke’s University Health Network – Anderson
St. Luke’s University Health Network – Upper Bucks
Temple Health – Temple University Hospital
The Midwife Center for Birth & Women's Health
Tower Health Medical Group - Reading Hospital
UPMC - Altoona
UPMC - Charles Cole
UPMC - Hamot
UPMC - Horizon
UPMC - Magee Womens Hospital
UPMC - Northwest
UPMC - Pinnacle Harrisburg
UPMC - Pinnacle Lititz
UPMC - Carlisle
UPMC - Pinnacle Hanover
UPMC - Pinnacle Memorial in York
UPMC -Susquehanna Soldiers + Sailors
UPMC - Susquehanna Williamsport
Washington Health System
Wayne Memorial Hospital
WellSpan Ephrata Community Hospital
WellSpan Gettysburg Hospital
WellSpan Good Samaritan Hospital
WellSpan Summit Health Chambersburg Hospital
WellSpan Summit Health Waynesboro Hospital
WellSpan York Hospital
*
2.
What is your name?
(Required.)
*
3.
What is your title/role?
(Required.)
4.
Has your hospital developed trauma-informed protocols in the context of substance use? (e.g., please see
Key Ingredients for Successful Trauma-Informed Care Implementation
)
Yes (in place)
No (working on it)
No (have not started)
5.
Does your hospital provide anti-racist training for providers, staff, and leadership?
Description: Anti-racist training is defined as a training that focuses on the "active process of identifying and eliminating racism by changing systems, organizational structures, policies and practices and attitudes, so that power is redistributed and shared equitably." The trainings also use this lens to address topics that are included in Diversity, Equity, and Inclusion trainings, such as unconscious and implicit bias, the meaning of diversity, equity and inclusion, stereotyping, reducing prejudice, cultural awareness and belonging, addressing microaggressions, and anti-harassment.
Yes (in place)
No (working on it)
No (have not started)
6.
Does your hospital provide training for clinical and non-clinical staff on substance use among pregnant and postpartum individuals that also express and address health care team members' biases and stigma related to substance use?
Description: Clinical and Non-Clinical Staff education and training should emphasize SUDs are chronic medical conditions that can be treated, stigma, bias and discrimination negatively impact pregnant people with SUD and their ability to receive high quality care, providers should match treatment response to each person’s stage of recovery and/or readiness to change, and federal, state, and local notification guidelines for infants with in-utero substance exposure and comprehensive family care plan requirements. This training should include trauma-informed care, naloxone and harm reduction strategies, regional and local data on SUDs, and regional and local support services, programs, and resources. Obstetric providers should consider receiving training on outpatient treatment of SUD, including MOUD (buprenorphine) to improve access to care.
Yes (in place)
No (working on it)
No (have not started)
7.
Does your hospital have evidence-based patient education materials focused on substance use in pregnancy and the caregiver's role in Substance Exposed Newborn care?
Yes (in place)
No (working on it)
No (have not started)
8.
If you responded "Yes (in place)" in
Question 7
, please check which substances your education materials address: (select all that apply)
Opioids
Sedatives
Stimulants (cocaine and amphetamines)
Alcohol
Tobacco
Marijuana
Other (please specify which substance(s) your educational materials address)
9.
Does your hospital provide education to pregnant and postpartum people related to naloxone use?
Yes (in place)
No (working on it)
No (have not started)
10.
Does your hospital have a system in place to provide naloxone to patients prior to discharge?
Yes (in place)
No (working on it)
No (have not started)
11.
Does your site use a validated, self-report screening tool for substance use in pregnancy?
Yes (in place)
No (working on it)
No (have not started)
12.
If you responded "Yes (in place)" in
Question 11
, please check the validated screening tool that is being used: (select all that apply)
4Ps
4Ps Plus
5Ps or Integrated 5Ps Screening Tool
NIDA Quick Screen (and if positive, the NIDA-Modified ASSIST)
Substance Use Risk Profile Pregnancy (SURP-P) Scale
CRAFFT (for adolescents)
Wayne IDUS
DAST-10
Prenatal Risk Overview-Drug Use (PRO)
AUDIT (specific to alcohol)
T-ACE (specific to alcohol)
TWEAK (specific to alcohol)
CRAFFT (specific to alcohol)
Other (please name and describe the screen, and please specify which substances that tool screens for: opioids, sedatives, stimulants (cocaine and amphetamines), alcohol, tobacco, marijuana, and others)
13.
For pregnant/postpartum individuals who screen positive for substance use, does your site have protocols and team roles in place to provide brief interventions that offer feedback to patients, explore readiness for behavior changes, initiate goal-setting, and refer to treatment?
Yes (in place)
No (working on it)
No (have not started)
14.
Does your site provide Medications for Opioid Use Disorders (MOUD) for pregnant individuals with OUD? (e.g., buprenorphine)
Yes (in place)
No (working on it)
No (have not started)
15.
Has your hospital developed referral relationships with any SUD treatment services in your area/county?
Yes (in place)
No (working on it)
No (have not started)
16.
If you responded "Yes (in place)" to
Question 15
, please indicate which recovery treatment services (check all that apply)
Programs offering Medications for Opioid Use Disorders (MOUD)
Residential Treatment
Inpatient Treatment
Outpatient behavioral health counseling
Peer support (e.g., certified recovery specialist (CRS) or other peer support specialists)
12-step program
17.
Has your site established specific prenatal, intrapartum, and postpartum care pathways (algorithms) for substance use that facilitate coordination among multiple providers during pregnancy and the year that follows?
Yes (in place)
No (working on it)
No (have not started)
18.
Has your hospital implemented post-delivery and discharge pain management prescribing guidelines for all vaginal and cesarean births focused on limiting opioid prescriptions?
Yes (in place)
No (working on it)
No (have not started)
19.
Has your hospital implemented specific pain management and opioid prescribing guidelines for vaginal and cesarean births for patients with OUD?
Yes (in place)
No (working on it)
No (have not started)