Peter H. Cherouny, MD, College of Medicine, Department of Obstetrics and Gynecology, University of Vermont, 111 Colchester Avenue, Burgess 223, Burlington, VT 05401, 802 847-5066, peter.cherouny@vtmednet.org, Jennifer R. Ustianov, RN, Vermont Child Health Improvement Program - VCHIP, University of Vermont, 5461 Arnold UHC Campus, One South Prospect, Burlington, VT 05402, Judith Shaw, RN, MPH, Department of Pediatrics, University of Vermont, One South Prospect Street, Burlington, VT 05401, Christine J. Zanfini, MA, March of Dimes, P.O. Box 605, Barre, VT 05641, and Michele Finn, MBA, National Office, March of Dimes, 1275 Mamaroneck Avenue, White Plains, NY 10605.

Wide variations in prenatal care exist despite published standards aimed at optimizing pregnancy outcomes. For example, in Vermont, two-thirds of women have inappropriate weight gain during pregnancy, more than 20% of pregnant women report smoking during pregnancy, and more than half of the Medicaid population does not return for a postpartum visit, all known contributors to pregnancy risk. The Institute of Medicine has stated that improvement in health care will only result from a redesign of existing care delivery systems. Therefore, a panel of 18 nationally recognized experts was convened in Vermont in August 2003 and provided the study group with prenatal care topic areas that are likely to have the highest impact on preterm delivery prevention for our population: nutritional counseling, smoking cessation, diabetic screening, STD screening and genetic and preterm risk assessment and counseling. Best care standards in these areas were presented for the purpose of identifying and developing specific and measurable changes that can occur within practice settings to achieve breakthrough improvement in the delivery of prenatal care in Vermont. Through a collaborative with the March of Dimes, NICHQ and VCHIP, learning session methods will be used as developed by the Institute for Healthcare Improvement Breakthrough Series to engage all prenatal obstetric providers in Vermont and their staff in learning both quality improvement methodologies and specific expert-panel recommended clinical content. These learned skills will then be used to redesign prenatal care within obstetric practices. This presentation will include the change strategies, including best care standards and specific measurable changes developed.

Learning Objectives: At the end of this session, participants will be able to

• Define a learning collaborative
• Assess prenatal practices for adherence to standards of prenatal care
• Describe quality improvement methodologies

Keywords: Prenatal Care, Practice-Based Research

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: March of Dimes Vermont Child Health Improvement Program (VCHIP) National Initiative for Children's Healthcare Quality (NICHQ)
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.