Louisiana Implementation of the National Fetal and Infant Mortality Review (NFIMR) Program Model: Successes and Opportunities
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Common features of successful, local-level, Fetal Infant Mortality Review (FIMR) Programs are identified by the National Fetal and Infant Mortality Review (NFIMR) Program, including medical records abstraction and home interviews, case reviews by a case review team (CRT), and community systems action recommendations implemented by a community action team (CAT). This paper presents Louisiana’s FIMR program, an adaptation of NFIMR recommendations. In 2001, the Louisiana Maternal and Child Health Program began a statewide FIMR Network (LaFIMR) based on the NFIMR model. Geographic areas of focus, case identification, staffing, data collection methods, and CRT and CAT membership and activities include modifications of the NFIMR recommendations unique to LaFIMR implementation. Adaptations made to the NFIMR model were advantageous to LaFIMR’s success. Specifically, LaFIMR geographic areas of interest cover multiple natural communities. Compared with independent FIMR programs elsewhere, LaFIMR represents a Title V Program-based coordinated network of regional LaFIMR teams offering opportunities for expanded partnerships. Primary sources for LaFIMR case identification include obituaries and hospital logs, with secondary identification available through vital records. Improvements in vital records data systems are expected to enhance future LaFIMR case identification. LaFIMR-identified records that are linked with vital event certificates provide enhanced contextual findings for reviews and support continuous quality improvement processes. These differences in the LaFIMR implementation reinforce the NFIMR-supported uniqueness of FIMR programs across the United States, and may encourage other FIMR programs to consider how adaptations to NFIMR recommendations could benefit their programs.
KeywordsInfant mortality Fetal and Infant Mortality Review Pregnancy outcomes review Program implementation
- 4.Kochanek K. D., Xu J. Q., Murphy S. L., Miniño A. M., & Kung H. C. (2011). Deaths: Final Data for 2009. National Vital Statistics Reports; vol 60(3): Hyattsville, MD: National Center for Health Statistics.Google Scholar
- 5.Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC (1999). Achievements in public health, 1900–1999: healthier mothers and babies. MMWR, 48, 849–858.Google Scholar
- 6.Xu J. Q., Kochanek K. D., Murphy S. L., & Tejada-Vera B. (2010). Table 30. Deaths: Final data for 2007. National vital statistics reports; vol 58(19): Hyattsville, MD: National Center for Health Statistics.Google Scholar
- 7.MacDorman M. F., Kirmeyer S. E., & Wilson E. C. (2012). Fetal and Perinatal Mortality, United States, 2006. National Vital Statistics Reports; vol 60 no 8. Hyattsville, MD: National Center for Health Statistics.Google Scholar
- 8.NFIMR website. www.nfimr.org. Accessed 24 Oct 2012.
- 9.Buckley K., Koontz A. M., & Casey S. (1998). Fetal and Infant Mortality Review Manual: A Guide for Communities. National Fetal and Infant Mortality Review Program. Out of print; information available from email@example.com.
- 10.Fetal and Infant Mortality Review Manual: A Guide for Communities. 2nd Edition. (August, 2008). National Fetal and Infant Mortality Review Program. Available at: http://www.nfimr.org/publications/Fetal_and_Infant_Mortality_Review_Manual_A_Guide_for_Communities_2nd_Edition. Accessed 17 Jan 2012.
- 11.Louisiana Vital Records and Statistics, Office of Public Health, Department of Health and Hospitals. http://www.dhh.louisiana.gov/index.cfm/subhome/21. Accessed 17 Jan 2012.
- 12.Health Insurance Portability and Accountability Act of 1996 (HIPAA). Available at: https://www.cms.gov/HIPAAGenInfo/Downloads/HIPAALaw.pdf. Accessed 17 Jan 2012.
- 13.Louisiana legislation RS 40:2018 governing the Louisiana Commission on Perinatal Care and Prevention of Infant Mortality. http://www.legis.state.la.us/lss/lss.asp?doc=97999. Accessed 17 Jan 2012.
- 15.BASINET (Baby Abstracting System and Information NETwork).http://www.gobeyondmch.com/basinet/ Accessed 17 Jan 2012.