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Report: Hospitals Target Hypertension, Hemorrhage to Improve Black Obstetric Outcomes

January 31, 2024

WASHINGTON — Focused efforts to reduce hypertension and hemorrhage in Black obstetric patients—including those to enhance equity and mitigate the effects of structural racism—improved outcomes at hospitals providing safety net care, a new report from Essential Hospitals Institute shows.

The Institute, the research, education, dissemination, and leadership development arm of America’s Essential Hospitals, with funding from the CVS Health Foundation, led a two-year learning collaborative to support work at 12 essential hospitals to reduce morbidity and mortality among Black pregnant and birthing patients. The collaborative supported sharing of results and best practices among the hospitals, including:

  • Alameda Health System Foundation, Highland Hospital, in Oakland, Calif.
  • Broward Health, in Fort Lauderdale, Fla.
  • Grady Memorial Hospital, in Atlanta.
  • JPS Health Network, in Fort Worth, Texas.
  • MedStar Washington Hospital Center, in Washington, D.C.
  • Memorial Healthcare System, in Hollywood, Fla.
  • Orlando Health Winnie Palmer Hospital, in Orlando, Fla.
  • SUNY Downstate Health Sciences University, in Brooklyn, N.Y.
  • Temple University Hospital, in Philadelphia.
  • University of California, San Diego Health, in San Diego.
  • UW Medical Center—Montlake, in Seattle.
  • Women & Infants Hospital of Rhode Island, in Providence, R.I.

According to the Centers for Disease Control and Prevention, Black birthing people are more than two and a half times likelier to die from a pregnancy-related cause than white birthing people. Racial and ethnic disparities in maternal mortality persist across socioeconomic strata. The pregnancy-related mortality ratio for Black birthing individuals with at least a college degree was five times as high as white birthing individuals with similar education. Members of America’s Essential Hospitals serve counties in which maternal mortality rates can exceed 52 maternal deaths per 100,000 live births.

Participating hospitals took a variety of successful approaches to improving Black obstetric outcomes, including providing racially concordant group prenatal care to reduce structural racism, expanding required trainings for all obstetric providers to include hypertension emergency simulations and anti-racism training, and providing enhanced wraparound services to meet social needs.

The report, Improving Black Obstetric Outcomes in Essential Hospitals, details each of the projects and the grantee’s perspectives on their work. It offers four recommendations to hospitals undertaking similar work:

  • Build a culture of equity at the institutional level.
  • Connect program activities to quality improvement initiatives.
  • Invest in health equity data training for program staff.
  • Establish trusting and lasting partnerships.

“This research shows that institutional commitment to equity is key to providing safer care for Black birthing patients,” says Kalpana Ramiah, DrPH, MSc, Institute director and vice president of innovation for America’s Essential Hospitals. “We hope it can serve as a model to other hospitals exploring this work.”

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About America’s Essential Hospitals
America’s Essential Hospitals is the leading association and champion for hospitals dedicated to equitable, high-quality care for all, including those who face social and financial barriers to care. Since 1981, America’s Essential Hospitals has advanced policies and programs that promote health, health care access, and equity. We support our more than 300 members with advocacy, policy development, research, education, and leadership development. Communities depend on essential hospitals for care across the continuum, health care workforce training, research, public health and health equity, and other services. Essential hospitals innovate and adapt to lead all of health care toward better outcomes and value.

About Essential Hospitals Institute
Essential Hospitals Institute is the research, education, dissemination, and leadership development arm of America’s Essential Hospitals. The Institute supports the nation’s essential hospitals as they provide high-quality, equitable, and affordable care to their communities. Working with members of America’s Essential Hospitals, we identify promising practices from the field, conduct research, disseminate innovative strategies, and help our members improve their organizational performance. We do all of this with an eye toward improving individual and population health, especially for vulnerable people.

Carl Graziano

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