If your hospital is participating in the PA AIM initiative, please complete this survey by April 30, 2022 for the January through March 2022 baseline period.

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

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* 2. What is your name?

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* 3. In this quarter, how many OB drills (In Situ and/or Sim Lab) were performed on your unit for any maternal safety topic? Please respond with whole numbers (e.g., 7)

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* 4. In this quarter, what topics were covered in the OB drills?

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* 5. At the end of this reporting period, what cumulative proportion of delivering physicians and midwives have completed (within the last 2 years) an education program on Severe Hypertension/Preeclampsia that includes the unit-standard protocol and measures? (Estimate in 10% increments, rounding up.)

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* 6. At the end of this reporting period, what cumulative proportion of OB nurses (including L&D and postpartum) have completed (within the last 2 years) an education program on Severe HTN/Preeclampsia that includes the unit-standard protocols and measures? (Estimate in 10% increments, rounding up.)

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* 7. At the end of this reporting period, what cumulative proportion of staff have completed (within the last 2 years) an education program on racial disparities and their causes, implicit bias, anti-racism strategies, or cultural humility? (Estimate in 10% increments, rounding up.)

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* 8. At the end of this reporting period, what educational program topics were covered related to racial disparities within the last 2 years? (Select all that apply)

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* 9. Has your hospital developed OB specific resources and protocols to support patients, family and staff through major OB complications?

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* 10. Has your hospital established a system in your hospital to perform regular formal debriefs after cases with major complications? (Major complications will be defined by each facility based on volume, with a minimum being The Joint Commission Severe Maternal Morbidity Criteria.)

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* 11. Has your hospital established a process to perform multidisciplinary systems-level review on cases of severe maternal morbidity (including at a minimum, birthing patients admitted to the ICU or receiving ≥ 4 units RBC transfusions)?

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* 12. Does your hospital have a Severe HTN/Preeclampsia policy and procedure (reviewed and updated in the last 2-3 years) that provides a unit-standard approach to measuring blood pressure, treatment of Severe HTN/Preeclampsia, administration of Magnesium Sulfate, and treatment of Magnesium Sulfate overdose?

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

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* 14. Has your hospital implemented quality improvement projects that target racial and ethnic disparities in healthcare access, treatment, and outcomes related to severe maternal morbidity or hypertension?

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* 15. Have some of the recommended Severe HTN/Preeclampsia bundle processes (i.e. order sets, tracking tools) been integrated into your hospital's Electronic Health Record system?

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* 16. Has your hospital established a process to collect patient-reported feedback on respect or equitable care?

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* 17. If you answered yes to question 16, what is your process for collecting patient-reported feedback on respect of equitable care and what tool is used to collect this feedback?

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* 18. If you answered yes to question 16, how frequently is patient-reported feedback on respect or equitable care collected?

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