For the first time, health care professionals will be able to use data on births that occur before the 39th week of pregnancy, thanks to enhancements a team of public health leaders developed for the Louisiana Electronic Event Registration System (LEERS).
LEERS is the state's web-based vital records system that captures data from modules for birth, death, fetal death, marriage and divorce records. A cross-departmental team that included representatives from LDH, the Louisiana Hospital Association and individual birthing hospitals recommended the LEERS enhancements for the birth module to track why babies are born before the 39th week, which medical professionals consider too early. With these data, LDH can create a real-time record of why preterm deliveries happen in Louisiana.
"We need to know when and why pre-term births happen to ensure Louisiana's babies have the best chance of living full, healthy lives," said LDH Secretary Bruce D. Greenstein. "With these changes to LEERS, we can see common factors or circumstances that cause women to have their babies too early. If you can't measure it, you can't manage it - and this information will give us the tools to identify risks faster and develop better policies and targeted interventions to prevent a preterm birth from occurring."
The team that led the LEERS modifications was part of the workgroup for LDH's Birth Outcomes Initiative, which targeted efforts to reduce the state's prematurity and infant mortality rates. In the past year, every birthing hospital in the state - 58 in all - pledged to end elective, non-medically necessary births before 39 weeks as part of this initiative.
"The Office of Public Health is constantly working to find solutions to our state's poor health outcomes. Developing better data systems will enable us to take a more targeted approach toward addressing the issues our state is facing in terms of the public's health. The modification of the LEERS Birth Module is an incredible first step toward building better maternal and child health data systems," said J.T. Lane, Assistant Secretary of the Office of Public Health, in reaction to the modification.
"Today, we know that Louisiana ranks 48th nationally in infant mortality and preterm birth, and 49th in the percentage of low birth weight and the percentage of very low birth weight babies, but we don't have the data necessary to understand why. This change will move the state's vital records system from measurement to action, empowering the Department to create meaningful policies," said Dr. Rebekah Gee who directs the Birth Outcomes Initiative and led the action teams.
Users of the Louisiana Electronic Event Registration System (LEERS) Birth Module began reporting data on deliveries prior to 39 Weeks on March 10, 2012. The state's LEERs system has been dramatically improved in the last year, thanks to efforts of Vital Records State Registrar Darlene Smith and her team. For instance, the amount of time between birth registration and mailing of the complimentary birth certificate has been reduced from 60 days to less than 3 days, and the amount of time between birth and registration has been reduced from an average of 72 days to 17 days.
The 39 Week Initiative is a voluntary program in which hospitals agree to establish policies to end the practice of elective, non-medically indicated deliveries prior to 39 weeks gestation. Through their participation in the Institute for Healthcare Improvement Louisiana Perinatal Care Collaborative, several of the state's largest birthing hospitals have already drastically reduced their percentage of 39 week deliveries.
"The LHA is proud of how hospitals in Louisiana have embraced the 39 week initiative and the goal of reducing unnecessary elective pre-term deliveries," said John Matessino, LHA president and CEO. "Woman's Hospital in Baton Rouge reduced its neonatal ICU days by 25 percent after initiating this policy, and other hospitals have seen drastic reductions in elective pre-term deliveries as well, further demonstrating the initiative's success."
Due to the demonstrated success of the Louisiana Perinatal Improvement Collaborative, LDH has opened enrollment in the program for a second year at a discounted price. Participating hospitals have access to national quality improvement experts who assist hospital based teams of physicians, nurses, and administrative staff on implementing the 39 week policy in their labor and delivery units and building capacity for in house data collection around the measure. For hospitals that cannot afford to pay for IHI, the March of Dimes last week announced they will be offering a limited number of 39 week quality packages for hospitals at no charge. Only 100 hospitals in the country will get the chance to use it. Applications for this free package are due April 15.
To learn more about the Birth Outcomes Initiative, visit www.boi.dhh.la.gov.