By August 14, please work with your team to complete this birth site-level survey for the period of April through June 2020.

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* 1. What is your health system name?

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* 2. Which site/hospital within your health system are you submitting data for?

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* 3. What is your name?

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* 4. At the end of this quarter, what is the cumulative percent of MFM/OB-GYN physicians, nurses, and midwives at the PA PQC hospital that has completed an education program on Obstetric Hemorrhage, Obstetric Hemorrhage bundle elements, and the unit-standard protocol within the last 2 years? (Estimate in 10% increments, rounding up)

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* 5. At the end of this quarter, what is the cumulative percent of MFM/OB-GYN physicians, nurses, and midwives at the PA PQC hospital that has completed an education program on Severe HTN/Preeclampsia, severe HTN/Preeclampsia bundle elements, and the unit-standard protocol within the last 2 years? (Estimate in 10% increments, rounding up)

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* 6. Does your hospital respond with a unit-standard, stage-based, obstetric hemorrhage emergency management plan with checklists?

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* 7. Does your hospital offer support programs for patients, families, and staff for all significant hemorrhages?

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* 8. Has your site established a system in your facility to perform regular, formal debriefs after cases with major complications?

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* 9. At the end of this quarter, what cumulative proportion of mothers had a hemorrhage risk assessment with risk level assigned, performed at least once between admission and birth and shared among the team? (Estimate in 10% increments, rounding up)

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* 10. Does your PA PQC hospital assess and re-assess your organization’s systemic racism and disparities, including the recognition and response to implicit bias and disparities?

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* 11. Does your PA PQC hospital engage diverse patient, family, and community advocates who can represent important community partnerships on quality and safety leadership teams?

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* 12. Does your PA PQC hospital implement quality improvement projects that target disparities in healthcare access, treatment, and outcomes?

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