Preterm Birth Prevention

Our statewide quality improvement initiative was developed in late 2018, with data collection and learning sessions spanning December 2019-October 2020.

9.3%

Preterm (Less than 37 weeks gestation) in Minnesota in 2019

67% Higher

Minnesota’s preterm birth rate among American Indian/Alaska Native women vs. all other women

$64k

Average cost of a preterm birth in Minnesota

1 in 11

In 2018, babies born preterm in Minnesota

The costs of prematurity are high.

Prematurity is the second leading cause of infant death in Minnesota (MN) and is associated with 24.7% of infant deaths from 2012-2016. In 2019, 9.3% of all MN babies were born prematurely. Significant health disparities by race and ethnicity also exist. American Indian (15.2%) and Black (9.7%) women have higher rates of preterm birth than White (8.6%) women (MDH infant mortality reduction initiative. (new paragraph) Personal and parental relationships can be disrupted and lifelong health problems in the infants can arise.

Furthermore, healthcare costs associated with prematurity are staggering. The average medical costs for a baby born at term are $4,389 compared to $54,194 for a premature baby (MOD). These costs translate to a $300 million excess expenditure for MN in 2017 . The prevention of preterm birth is critical to supporting long-term infant health, promoting health equity, and controlling healthcare costs.

Objectives

Increase by 25% or more the accessibility and use of 17P in five health care systems in MN by April 2020 and by 50% by October 2020 so that:

  • 1. 95% or more of women are assessed for preterm singleton birth at first perinatal visit up to the 24th week of pregnancy.

  • 2. 95% or more of eligible women based on the preterm term treatment algorithm are offered 17P. 

  • 3. 95% or more women are explicitly asked what matters most to them about their pregnancy and birth. 

  • 4. 95% or more of all women with preterm singleton birth history are offered teach back on value of 17P.

  • 5. The time between prescribing and administration of first 17P dose is reduced to 10 days or less.

  • 6. Adherence increases to 80% or more of eligible 17P doses.

  • 7. 90% or more of women receiving 17P have a follow up “touch” at internals coproduced by care team and the woman

Faculty

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

MBA, MHA, Ed.D

Jane Taylor is an Improvement Advisor and Learning Designer.  She supports learning collaboratives, networks, and innovation projects by providing expertise in improvement approaches and measurement. She has advised over 100 collaboratives for both adult and pediatric populations. Jane has worked with many states on reducing infant mortality, maternal health, medical home, primary and specialty care, reducing readmissions; to name a few. She also focuses on building quality improvement capability and improving healthcare around the world. Also, Jane is keen on reducing disparities of care and developing equity and in both primary and acute care settings.  Dr. Taylor has leadership experience as a hospital CEO and COO for over ten years and as an improvement consultant to healthcare for 20 years.  She is a wife, sister, and loving friend to many.

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.

Yasuko Yamamura

MNPQC Executive Branch

Dr. Yamaura is an Assistant Professor in the Department of Obstetrics, Gynecology, and Women’s Health at the University of Minnesota. She completed her residency in Obstetrics and Gynecolgoy at Mayo Clinic in Rochester, MN and a fellowship in Maternal-Fetal Medicine at the University of Minnesota. In addition to being an active clinical partner in the University MFM practice, she also serves ACOG District VI Champion for FASD Prevention and is the Maternal-Fetal Medicine Fellowship Director at the University of Minnesota. Her primary interests are medical education and preterm birth prevention. Dr Yamamura is board certified in Obstetrics and Gynecology and has a subspecialty certification in Maternal-Fetal Medicine.

Working Group

Beth Elfstrand

MN-ACOG

Dr Elfstrand has been a practicing physician in Minneapolis for 26 years. She has served in leadership roles at Abbott Northwestern Hospital for over a decade and served on Alina pregnancy care council for many years and worked on multiple quality projects. She is serving as chair of ACOG in MN and go to several district and national meetings each year.

Alina Kraynak

MDH

No bio at this time.

Katie Linde

MDH

No bio at this time.

Leslie Morrison

AWHONN MN Section

Leslie has her BSN, MS, and PhD from the University of Minnesota and is a certified nurse midwife, RN, and registered public health nurse. She teaches at Metropolitan State University, focusing on undergraduate research and epidemiology courses, women’s health, and public health. She is on her second year of a three year term as full-time department chair for the Department of Nursing. Her dissertation focused on contraceptive practices of emerging adult women.

Anna Mueller

MVNA/HCMC

Anna has worked as an RN since 2001 in a variety of areas including postpartum/newborn care, labor & delivery, lactation consulting, maternal fetal medicine (obstetrical testing), childbirth education. She has been the Clinical Director for Family Health at MVNA since 2015. MVNA operates five evidence based and evidence informed home visiting programs that provide services to families living in Minneapolis and suburban Hennepin County.

Carl Rose

Mayo MFM

No bio at this time.

Julie Shelton

Essentia Duluth

Julie Shelton DNP, APRN, CNS for the Birthplace/NICU at Essentia Health St. Mary’s Medical Center Duluth, MN. She has worked for 33 years as an RN at this facility. She has been the Education Coordinator at a critical access hospital, the Coordinator for our High Risk OB Clinic and our NICU Follow-Up Clinic. She is responsible for system initiatives and quality metrics. She provides education for staff surrounding High Risk OB and Critical Care Obstetrics.

Darrah Solitario

UMN Women’s Health Specialists Clinic

No bio at this time.

Denise Turk

Fairview MFM Clinic Administrator

Denise Turk is the Director of Women’s Care, overseeing four Maternal Fetal Medicine Centers for M Health, Fairview. Denise’s areas of interest include change management, organizational process optimization and implementation of best practice. She has over 20 years’ nursing experience dedicated to the care of women through high risk pregnancy. When away from work, Denise enjoys gardening and spending time with her family.

Andrea Winter

Park Nicollet Women’s Services

Andrea Winter has been a leader in women’s health for over 20 years. She joined Park Nicollet in 2001 and has held several leadership positions within primary care and surgical services. In her current role as Sr. Director of Women’s & Children’s Strategy, she is responsible for the strategic business development of Women’s and Children’s services across the HealthPartners care delivery system. She also co-leads the Children’s Health Initiative, a system wide effort to improve maternal and child health. Andrea partners with leaders across the organization, and in her community, to plan coordinate and execute strategic growth opportunities. Andrea has been involved with March of Dimes since 2016 serving on the Minnesota Market Board, chairing the Maternal Health Committee and serving as the 2018 Twin Cities March For Babies Chair. Andrea holds a master’s degree in business administration from the University of St. Thomas and a bachelor’s degree in Healthcare Administration for the University of Wisconsin – Eau Claire.

Healthcare Systems Involved in the PTB Initiative

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