Join us as we begin the essential work for moms and babies in clOUDi 3.0 - this ambitious initiative will not only continue to address the opportunities we have in achieving 1) 100% validated verbal screening for substance use disorder in pregnant North Carolina mothers 2) 100% of mothers screening positive for opiod use disorder (OUD) referred for treatment 3) All mothers screening positive for OUD receive education regarding the care plan for their baby after birth 4) Transitioning the state to ESC in the care of infants at risk for NAS/NOWS and 5) 100% of families of infants treated as at risk for NAS/NOWS offered a Plan of Safe Care prior to discharge.
In addition we will be attempting to put in place 1) 100% screening of all mothers for anxiety and depressive disorders at some time during the delivery period 2) An effective Safe Sleep conversation with every family prior to discharge with their new baby and 3) Naloxone in hand for all mothers with a positive OUD screen leaving the hospital after delivery.
Wow. That is a lot, but we all knew these things needed to be addressed. We overwhelmingly said so in voting for clOUDi every year for the last 3 years.
Much has been achieved over the first two years of clOUDi, but there is more to be done before concluding our formal focus on OUD. All of us at some time may have felt that we have done what we can in this initiative. We have done a lot, but the data tells us we must try and find a second wind. Maternal drug overdose and suicide are now the leading causes of maternal mortality. Deaths from drug overdoses have risen dramatically over the last three years.
What we are doing in clOUDi is saving lives. You may not see it in hospital based mortality statistics, but we all will see it in state based measures that follow moms when they leave the hospital after delivery. When we identify mothers with an OUD or mental health issue prenatally or perinatally, we have the ability to offer care and treatment which can change lives. We may save a mother from overdose or suicide, or an infant from a sudden unexplained infant death or offer a vulnerable mother the opportunity to recover, rehab, and experience a new life as a loving mother.
The scourge of opioid use disorder and mental health pathologies are challenging. Confronting these twin beasts in our hospitals and clinics cannot succeed without a true joint, collaborative effort. This is required in the hospitals and clinics, where providers and patients in the trenches who can influence care paths need to partner with organizational leaders who truly appreciate the stakes in this race. It is likely that 1-2% of all NC births are complicated by OUD. There are significant mental health challenges intertwined in many if not most of these cases. This collaborative effort is also required at the state level. We all need to learn from and support each other. This is the formula for making North Carolina the best place to give birth and be born.
For clOUDi 3.0 to be successful, we need all hands on deck. OUD and maternal mental health are issues that impact every single birthing center and maternity clinic in this state. For many PQCNC warriors neck deep in this project the last two years, that means asking you to extend your commitment to the clOUDi effort. However, as tired as some are, it also means we need to recruit other colleagues to the fight...other nurses, midwives, NPs, patients, family members, docs, social workers, lactation consultants. More, hospital and clinic leaders need to make certain executive leaders know why this effort is critical and are updated on your activities. We at PQCNC are willing to do anything we can to support facilitating local team development and making the case to organizational leaders.
The formal clOUDi intervention is done December 2023. We have one more year to challenge culture, address biases and put processes in place that will assure willing mother, families and their children the best possible outcomes for years to come. The ask here is that you generate the clOUDi 3.0 discussion now. Convene the possible team members. Make it clear the work is not a huge time commitment, especially if a few individuals are willing to pledge support. Have all review the clOUDi 3.0 description linked here and then commit to joining this fellowship determined to save the lives of moms and babies affected by OUD and mental health conditions.
Thank you to the 53 teams that have worked feverishly in clOUDi 1.0 and 2.0. Let’s make it 75 teams as we all link arms in the finale clOUDi 3.0.
Let’s all commit to meeting in December 2023 as PQCNC throws an outrageous bash with 75 mothers, babies, their families and our clOUDi 3.0 teams celebrating the lives of at least one mom and baby our hospital team changed forever.
We must do this!
Burn the ships….the only way is forward!