COIN Working to Ensure Health Equity

By Reem M. Ghandour, DrPH, MPA
Office of Epidemiology and Research, Maternal and Child Health Bureau

HRSA has begun to intensify efforts to prevent premature births and improve birth outcomes. For example, MCHB has launched a Collaborative Improvement and Innovation Network (COIN) to reduce infant mortality in the 13 southern states of Regions IV and VI. As described by Dr. Michael Lu, associate administrator for maternal and child health at HRSA: "States and their partners are leading the way in efforts to reduce infant mortality. The COIN provides a platform for collaborative improvement and innovation across state lines."

The COIN builds on the success of the Infant Mortality Summit held in January 2012, at which the 13 states in Public Health Regions IV and VI developed plans to reduce infant mortality. In response, MCHB, in partnership with AMCHP, ASTHO, the March of Dimes, CityMatCH, and federal partners, including CDC and CMS, launched the COIN to facilitate collaborative learning and adoption of proven quality improvement principles and practices across these 13 states to reduce infant mortality and improve birth outcomes.

From these efforts, five common priority strategies emerged, as well as the desire to share best practices and lessons learned across the region. The COIN will demonstrate the impact of five key strategies on infant mortality: 1) eliminating elective deliveries prior to 39 weeks gestation, 2) prenatal smoking cessation, 3) safe sleep for infants, 4) Medicaid financed interconception care for women with a prior adverse pregnancy outcome and 5) strengthened regional perinatal care systems. Working across state lines, teams have formed around each of the five strategies comprised of representatives from all 13 southern states.

Collaborative improvement and innovation are the focus of work going forward. The Regions IV and VI COIN was formally launched on Jul. 23-24, 2012 in Washington DC, where the five COIN teams met face-to-face for the first time to receive training on the science and practice of quality improvement and collaborative learning, as well as to hear about current public and private efforts to reduce infant mortality and improve birth outcomes across the nation. Through the COIN, state agencies across the 13 southern states are designing modern, effective approaches for change. More than 200 committed professionals from the southern states are volunteering their time and expertise to the COIN. Together, these leaders are focusing on ways to ensure health equity, eliminate health disparities, and implement best programs, policies, and practices to reduce infant mortality.