Idaho Perinatal Quality Collaborative: Interest form

The Maternal and Child Health Program of the Idaho Department of Health and Welfare and Comagine Health have partnered to establish Idaho’s Perinatal Quality Collaborative (PQC). We need people and organizations like yours to join us!

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* 1. We'd like to know how to contact you.

Name

Organization

City/Town

ZIP/Postal Code

Email Address

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* 2. What is your role at your organization?

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* 3. What are your credentials (if applicable)?

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* 4. What are you interested in learning more about/participating in? Select all that apply.

I'd like to be a PQC Champion and help get this PQC off the ground

AIM Patient Safety Bundle implementation

General PQC updates/progress

Data collection and analysis

Other (please specify)

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* 5. In your opinion, what are the most pressing issues in maternal health in Idaho? Select all that apply.

Substance Use Disorder/Opioid Use Disorder

Mental health

Hemorrhage

Sepsis

Hypertension

Post-partum care

Other (please specify)