Mother/Infant Opioid Substance Use Treatment and Recovery Effort (MOSTaRE)

Interested in Getting Involved?

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The MOSTaRE Initiative will:

  • Emphasize family-centered care that maintains the maternal-infant dyad
  • Address treatment and prevention of substance exposure during pregnancy for mother and infant

Starting fall 2022, is open to all Minnesota birthing facilities and an ongoing enrollment. Engagement will include monthly action calls (available only to hospital teams) and monthly ECHO calls available to all. This project will satisfy new CMS guidelines for hospitals to collaborate with state PQCs. Hospitals interested will receive an orientation packet with details.

For more information please contact Susan Boehm susan.boehm@minnesotaperinatal.org

These are a variety of resources provided by MPO/MNPQC and other organizations for healthcare providers and the public. Many links are provided by other organizations and are subject to change without notice.


AIM

Perinatal

By December 2023, our aim is to increase the identification and treatment of substance use disorders (SUDs) in pregnant people and substance exposure in infants by 50% or more in order to improve pregnancy and postpartum outcomes, increase the use of non-pharmacologic methods for treating infants exposed to opioids and reduce the average length of stay for these infants.

Charter

The Mother/Infant Opioid and Substance use Treatment and Recovery Effort (MOSTaRE) purpose is to work with providers, hospitals, and other stakeholders to improve identification, clinical care, and coordinated treatment/support for pregnant and parenting individuals with opioid use disorder and their infants through a family-centered care approach. 

The MOSTaRE Initiative will emphasize family-centered care that maintains the dyad and will address treatment and prevention of substance exposure during and after pregnancy for both mother and infant.

Team Membership (includes both infant/perinatal arms)

  1. Infant Team Members include:  NICU, general pediatric or family practice provider, community treatment and support partners, women with lived experience 
  2. Perinatal Team Members include:  prenatal, delivery, and postpartum providers; treatment and community support members, women with lived experience 

Full Charter Here

Family Of Measures

Stratify by race/ethnicity where available.

State Surveillance:

  • SUD among pregnant and postpartum people (SS1)
  • Severe Maternal Morbidity (SMM) (including transfusion codes) among people with SUD (SS2)
  • Severe Maternal Morbidity (SMM) (excluding transfusion codes) among people with SUD (SS3)
  • Proportion of pregnancy associated deaths due to overdose (SS4)

Outcome Measures

  • Percent of newborns exposed to substances in utero who were discharged to either birth parent (O1)
  • Percent of pregnancy and postpartum people who received or were referred to recovery treatment services (O3)
  • Length of stay of all opioid exposed newborns

Process Measures:

  • Percent of pregnant and postpartum people screened for SUDs (P1)
  • Number of Provider and Nursing education-SUDs (P5)
  • Number of Provider and Nursing education- Respectful and Equitable Care (P6)

Structure Measures:

  • Resource Mapping/ Identification of Community Resources (S1)
  • Number of Patient Event Debriefs (S2)
  • General Pain Managment Guidelines (S3) 
  • OUD Pain Managment Guidelines (S4) 
  • Validated Verbal Screening Tools and Resources Shared with Prenatal Care Sites (S5)

Toolkit


Eat Sleep Console

Coming Soon.

Family Care Plan

The Family Care Plan is a document created jointly by a pregnant or parenting person, and their provider. This document helps to think about what services or supports they might find useful, to record their preparations to parent and organize the care and services they are receiving. A FCP can be any family service plan that covers both the parents’ behavioral health/recovery services (including addiction and mental health supports) and family or child-focused services (such as referral to Early Intervention and prenatal care appointments). To learn about the Family Care Plan and the statewide effort around implementing it into your practice.

Naloxone

Coming Soon. 

Resources

Webinars

Wayside Recovery Center
Perinatal Substance Use & Reporting Laws
Presented by Dr. Cresta Jones, MD, FACOG
March 2022

MNPQC Townhall
Response to changes in reporting of Prenatal Exposure to Controlled Substances
CPS Panel featuring Hennepin, Ramsey, Anoka,
and Beltrami County
May 11, 2022


MOSTaRE Update (Mother/Infant Opioid and Substance Use Treatment and Recovery Effort)
The Mother/Infant Opioid and Substance use Treatment and Recovery Effort (MOSTaRE) Initiative is now underway in Minnesota hospitals! We had our first learning session virtually on September 28 with eleven different hospital teams! We learned about creating PDSA cycles (plan, do, study, act) and got familiar with the Simple QI program to collect our data. Each hospital team will individualize their goals, determine data metrics that are important to their facility and test change ideas that were developed by MNPQC’s statewide workgroup, while collaborating with other teams.

Our monthly Action Period Calls will start in November on the first Wednesday of each month, if your hospital is interested in joining us, please email Susan Boehm (susan.boehm@minnesotaperinatal.org).  

We would love to have every hospital in the state participate. A key recommendation from the Maternal Mortality Review Committee is “to support statewide improvements for birthing people who have substance use disorder” so we know this project is an important piece of improving the health and lives of Minnesota patients.

Thank you and welcome to all who joined us – we look forward to meeting in person at the next learning session!

Dr. Adrienne Richardson, MOSTaRE Chair

Faculty

Working Group

Adrienne Richardson

MOSTaRE Chair

MD, Ob/GYN | HealthPartners

Rachel Cooper

MOSTaRE Vice Chair
Sanford Health

Rachel is an Mpls native who went to South High School. Undergrad at New York University, Master’s in Bioethics at Columbia University, Medical School at the U of MN, Pediatrics Residency at the University of WI in Madison. Currently working as a Peds Hospitalist, covering Newborn Nursery, Special Care Nursery, Peds Floors, and Peds Consults in Bemidji, MN at Sanford Bemidji Medical Center. Special interests include health equity, pediatric and adult bioethics/conflict resolution/decisionmaking, pediatric hospice, and palliative care. Previous work as an EMT, Spanish, and French medical interpreter. 

Anne Walaszek

MNPQC Executive Branch

Anne Walaszek, MPH (Anishinaabe) is the Maternal and Child Health Quality Improvement Specialist in the Women and Infant Health Unit at the Minnesota Department of Health. In her role, she leads two quality improvement grants, the Perinatal Quality Collaborative and the Communities Collaborating to Prevent Girls Opioid Abuse. Ms. Walaszek has experience working at a national non-profit addressing cancer inequities within American Indian and Alaska Native communities. In this role, she provided leadership for a clinic and community health approach to develop and implement culturally tailored evidence-based interventions to effectively build capacity in health systems across Indian Country. Her public health experience reflects grant writing, program development, research and data management throughout her experiences at the Minnesota Department of Health Diabetes Program, Institute of Child Development at the University of Minnesota, and SAMHSA for their Child, Adolescent and Family Branch. She is a 2017 recipient of the Lou Fuller Award for Distinguished Service in Eliminating Health Disparities.

Jane Taylor

Ed.D., Hospital & Health Care Consultant, Contractor, and Advisor to Improvers and Learners.

Susan Boehm

MPO Executive Director/Treasurer, MNPQC Co-Director


Susan has been a Clinical Nurse Specialist in Women’s Health for over 30 years. She has a long history with MPO as a volunteer, conference presenter, planning committee member, and has served on the Board of Directors. She is currently the MPO Executive Director and Co-Director of the Minnesota Perinatal Quality Collaborative (MNPQC).

She enjoys the outdoors, hiking and kayaking, and loves the solitude of their cabin in the Boundary Waters.

Todd Stanhope
North Memorial, MNPQC Executive Branch

Dr. Stanhope is a full-time OB/Gyn hospitalist and medical director of Women’s and Children’s services at North Memorial Health Hospital. His clinical interests include hypertension, complex deliveries, and postoperative opioid prescribing. Prior to his current position, he provided contracted OB coverage at a number of facilities, high and low volume, in several states and completed two missions to South Sudan with Doctors Without Borders from which he gained invaluable experience learning the myriad needs and challenges of different facilities and systems face.


Adrienne Richardson

Health Partners

Alina Kraynak

Minnesota Department of Health

Alison Newton

DNP Student at the University of Minnesota

Amy Bea Bowles

Sanford

Bea is a masters prepared nurse, with an emphasis in Leadership and has been working in healthcare since she was a teenager. In addition to LTC, she has worked in ortho/neuro, surgical, public health, home care, obstetrics, pediatrics, teaching (NDSCS and NDSU –go Bison!), and most recently learning the special care nursery world. She is blessed with an amazing leadership team and a wonderful team of staff to serve. After 22 years of living in Fargo, she relocated to Bemidji; she loves her new location and looks forward to serving the patients in their hospital as well as her community. She has been married for 21 years and has three children, 1 dog, and one snake.

Brian Grahan

Hennepin Health

No bio at this time.

Courtney Higginbotham

U of M Institute on Community Integration

Chris Derauf

MD | he/him/his
Professor | Mayo Clinic Alix School of Medicine
Consultant | Mayo Clinic | Department of Pediatric and Adolescent Medicine | Division of Child Abuse Pediatrics | Mayo Clinic Center for Safe and Healthy Children and Adolescents

Cresta Jones

Cresta Jones is a maternal fetal medicine physician and associate professor at the University of Minnesota Medical School. She is also board certified in addiction medicine. She received her medical degree from the Medical College of Wisconsin and completed her residency and fellowship at the University of Vermont. Dr. Jones clinical work includes a focus on best practices for perinatal substance use disorder treatment. She is the co-director of a perinatal substance use and mental health ECHO series through Hennepin Health. Her research interests include the effects of prenatal opioid exposure on neonatal outcomes, and patient education surrounding preterm birth. 

Daniela White

MA, LPC, LADC- Women Services Programs at the Department of Human Services, Behavioral Health Division.

Deb Peters

Essentia Health

Lead Neonatal Nurse Practitioner in Duluth, MN for the past 25 years.

Erin Plummer

Children’s

Erin is a neonatologist at Children’s Minnesota. She completed her pediatric residency and neonatology fellowship at the University of Minnesota. Dr Plummer specializes in neonatal critical care at Children’s Minnesota. She is originally from Ohio and attended medical school at Wright State University Boonshoft School of Medicine in Dayton, OH. She completed her residency and fellowship at the University of Minnesota Medical Center. Her clinical interests include nutrition, growth, and neurodevelopmental outcomes in premature and critically ill infants. She is passionate about caring for infants hospitalized in the NICU and building relationships with their families. Dr Plummer is involved in the education of neonatal fellows, pediatrics residents, family practice residents and medical students. She lives in Minneapolis with her husband and two children.

Erin Morris

University of Minnesota

Erin Morris is a Neonatal-Perinatal medicine fellow at the University of Minnesota. Her research interests include nutrition and neurodevelopment of infants in the NICU and specifically of those with prenatal drug exposures. She is currently involved in a QI project through the University of Minnesota involving the implementation of the Eat, Sleep, Console treatment for infants with prenatal opioid exposures.

Frances Prekker

Frances Prekker, MD is a Pediatric Hospitalist with Hennepin Healthcare. She is the Medical Director of both the Newborn Nursery and Pediatric Inpatient Unit at Hennepin County Medical Center. She has a special interest in the care of substance-exposed newborns, perinatal substance use, and providing care that preserves the mother-infant dyad. She has led many QI projects at HCMC improving care for infants experiencing withdrawal, keeping moms and babies rooming in together, and reducing bias in newborn drug testing.

Jennifer Hall-Lande

Ph.D, MN-ADDM

Kari Rabie

Native American Community Clinic

As a physician serving the Native American Community in Minneapolis, Dr Rabie is passionate about addressing the significant health disparities that impact Native Americans in Minnesota. To address these disparities she became buprenorphine waivered, and pursued specialty in Addiction Medicine. She is also passionate about educating the next generation of physicians to provide care to the Native Community in the context of community medicine. She provides care using the lens of harm reduction.

Kelcee Kociemba

Kelcee currently works in a private practice setting with special training in maternal mental health specifically perinatal mood and anxiety disorders. 

She also works in Adult Mental Health as a county case manager, previously working in child protection as well. She has a variety of experiences within rural communities.

Laura Newton

Minneapolis American Indian Center

No bio at this time.

Liz Corey

Minneapolis Department of Health

Megan Warfield-Kimball

Benefit Policy Specialist at Minnesota Department of Human Services 

Meagan Thompson

Meagan Thompson, DNP, APRN, CNM, has a BA in Sociology from the University of Wisconsin Madison in Sociology, with minors in American Indian Studies and Women’s Studies. She worked as a reproductive health educator before returning for her Masters of Nursing (MN) at the University of Minnesota-Twin Cities. In her role as a reproductive health educator, she created educational content to engage young people in their social, emotional, and reproductive health in a variety of settings. After receiving her MN degree, Meagan worked as an RN in a high-acuity tertiary care labor and delivery unit. While working as a bedside nurse, Meagan pursued her Doctorate of Nursing Practice (DNP) degree in the Nurse-Midwifery specialty. During her DNP program, Meagan participated in the Leadership Education in Adolescent Health (LEAH) Fellowship. She worked as part of an interdisciplinary cohort to learn the basics of research, grant writing, and interprofessional collaboration. Her fellowship project examined reproductive outcomes for incarcerated adolescents. Meagan is currently enrolled in a Psychiatric Mental Health Nurse Practitioner (PMHNP) certificate program through the University of Iowa. Upon graduation, she will be a dual-certified CNM/PMHNP provider uniquely qualified to care for perinatal substance use disorders. After graduation from the DNP program, Meagan worked at the University of Iowa where she received funding to implement universal SBIRT and create a maternal substance use disorder (MSUD) clinic. She worked as the primary provider in the MSUD clinic before returning to MN.

Samantha Sommerness

University of Minnesota School of Nursing

Sarah Riedel

Tri-County Health Care

RN, BSN, IBCLC, CPST

Sarah is the OB Supervisor of a critical access hospital in Midwestern Minnesota. She has been married to her husband Nathan for 28 years. They live on a farm with beef cattle and pigs, and have 3 children- Daniel is 23, Megan is 18, and Abby is 16. Sarah has worked at TCHC for 28 years, first as a CNA, then LPN, then RN, BSN, IBCLC, and finally OB Supervisor.

Shelly Mahowald

Shelly recently celebrated her 30 year anniversary in nursing, most of those years focusing on moms and infants. Recently, finishing a nurse practitioner program and started in the Medication Assisted Therapy clinic working with clients working through substance use disorders. She will lend experiential expertise to the MNPQC in the areas of perinatal safety around the education of staff and providers through simulation.

Interested in Getting Involved?
Need More Info?