FIMR: Effective community collaboration lead by PHN's

The background of this clinical challenge is the infant mortality's racial disparity and the leadership role of public health nursing in the Fetal and Infant Mortality Review (FIMR) process. Public health nurses are leading the effort for community based approaches to resolve infant mortality disparities. These nursing leaders are using the FIMR process to provide a forum for community leaders to address the tragic loss of an infant. The overall goal of the FIMR methodology is to enhance the health and well-being of women, infants and families by improving the community resources and service delivery systems available to them. Community based FIMR is an action-oriented continuous quality improvement process that is playing a significant role in building community partnerships, understanding community issues and developing culturally sensitive interventions. In the recent national evaluation of the FIMR process, Johns Hopkins University described FIMR as a valuable public health tool and an effective perinatal systems intervention. Today, there are about 200 FIMR programs located in 40 states, the District of Columbia, the US Virgin Islands and the Commonwealth of Puerto Rico. Lessons learned through implementation of FIMR is that communities will address their health issues if given information and forum for resolution. FIMR is a community coalition that engages a diverse membership to address community issues. This process has resulted in appropriate health education materials and community services. For example, premature labor and safe sleep brochures in language of users. As a result of these successes, we recommend that communities not currently providing FIMR should consider implementation of this process. Specifically, for public health nursing, it provides a tangible process to address infant mortality disparities.