Cutting-Edge Practice

Center of Excellence for Perinatal Substance Use – Hospital Certification

State/Jurisdiction: Washington
Setting: Clinical
Population: Medical & Public Health Professionals
Topic Area: Access to Quality Healthcare Mental Health & Substance Use Care Coordination Birth Outcomes Workforce Development Community Wellness
NPMs:

The Centers of Excellence for Perinatal Substance Use (COE) program addresses a critical gap in perinatal healthcare by supporting hospitals in providing comprehensive, evidence-based care for birthing women affected by substance use disorder (SUD). This need was identified following the 2019 Washington State Maternal Mortality Review Panel (MMRP) report, which highlighted that opioids were a leading factor in pregnancy-related deaths due to substance use and accidental overdose. The MMRP recommended the implementation of protocols to improve outcomes for pregnant and postpartum women with SUD. In response to this, the Washington Department of Health (DOH) and the Washington State Hospital Association (WSHA) piloted the Alliance for Innovation on Maternal Health (AIM) safety bundle, Obstetric Care for Women with Opioid Use Disorder, with 13 hospitals. This laid the groundwork for the creation of the Centers of Excellence for Perinatal Substance Use Certification.

In 2020, the DOH, WSHA, and Health Care Authority (HCA) began the development of the COE, which includes 10 key criteria hospitals must meet to achieve certification. These criteria focus on critical aspects of care, such as standardized screening for SUD and mental health disorders, access to healthcare providers who can initiate and adjust medication for SUD, and ensuring policies that support keeping the postpartum woman and infant together, except in extenuating circumstances.

To further refine and enhance the certification process, the team conducted multiple hospital listening sessions to better understand the unique challenges and needs of birthing hospitals. A steering committee was established, consisting of people with experience being pregnant and giving birth with a substance use disorder, subject matter experts from HCA, WSHA, AWHONN, hospital care team members, and leading national experts in substance use and pregnancy.

As a result of these activities, the Perinatal Substance Use Disorder Learning Collaborative was launched, with the purpose of supporting hospitals in meeting the COE criteria. This collaborative engaged 77% of hospitals in the state and offered monthly learning sessions, peer support, technical assistance from regional nurse coordinators, quality improvement tools, and an online toolkit with resources and materials to assist in the implementation of best practices.

The Learning Collaborative and COE program primarily impacts the medical and public health professionals that interact and care for pregnant and postpartum women with substance use disorder and their infant. It seeks to promote systemic changes across hospitals, ensuring they adopt best practices for screening, treatment, and care coordination for people with substance use disorder. The COE certification recognizes hospitals that have demonstrated excellence in implementing these practices, setting a standard for high-quality, compassionate care.

The Perinatal Substance Use Disorder Implementation & Policy Hub project is supported by the Foundation for Opioid Response Efforts (FORE) and Perigee Fund. The content presented is the responsibility of the featured practices and policies and does not necessarily reflect the views of FORE, Perigee Fund, or AMCHP.

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CONTACT INFORMATION
WA State Department of Health
Tiffany Tibbs Christensen
Tiffany.TibbsChristensen@doh.wa.gov

Practice Website


For more information about this practice, please email evidence@amchp.org