242: Hospital readiness to care for mothers and newborns affected by opioids

The Illinois Perinatal Quality Collaborative (ILPQC) launched a Mothers and Newborns affected by Opioids (MNO) quality improvement (QI) initiative in May 2018 to improve outcomes for mothers and newborns affected by opioids with 107 hospitals by improving identification of women with opioid use disorder (OUD), linkage to treatment, and optimizing care for moms and newborns affected by opioids consistent with new national guidelines. We aim to assess hospital readiness to care for mothers and newborns affected by opioids and how barriers to care vary by hospital characteristics. We distributed the MNO-OB Readiness Survey to all participating hospitals with rosters submitted as of May 2018. Teams reported baseline readiness for improving care for mothers with OUD. We conducted descriptive analysis of the data for hospital readiness and used ANOVA to evaluate how barriers varied by hospital characteristics. Fifty-four of 81 (67%) participating hospitals as of May 2018 completed the MNO-OB Readiness Survey. Hospital characteristics are available for 46 hospitals (Table 1). Survey results (Table 2) showed hospitals at baseline do not have adequate protocols and processes in place for women and newborns affected by opioids The majority of hospitals are not using a validated screening tool for OUD; do not have a protocol for screening women and linkage to treatment; have not identified local resources to link to Medication-Assisted Treatment (MAT); do not provide referrals to MAT, Narcan counselling, or neonatal consult to discuss care of the opioid exposed newborn. Hospitals faced significant barriers linking women with OUD to addiction services regardless of hospital characteristics and few reported office-based buprenorphine (24%), methadone treatment programs (26%) and drug and alcohol counseling (34%) were readily available (at hospital or by referral). Hospitals have opportunities for improvement in standardizing screening and linkage to care, accessing key services for maternal OUD treatment, and providing pregnancy care for women with OUD and engaging women with OUD in the care of their newborn. Results suggest that a statewide QI effort is needed to achieve current national guidelines for optimal care of mothers and newborns affected by opioids and improve outcomes for these at-risk mothers and newborns.View Large Image Figure ViewerDownload Hi-res image Download (PPT)