Fetal and Infant Mortality Review

by Thomas M. Miller, MD

National Fetal and Infant Mortality Review Program

2

Collaborative effortBegan in late 1980’sMore than 220 programs40 states, the District of Columbia, Puerto

Rico, and the Virgin Islands15 statewide programs

FIMR Goals

3

To describe significant social, economic, cultural, safety, health and systems factors that contribute to mortality

To design and implement community-based action plans built upon information obtained from the reviews

FIMR Model - ACOG Guidelines

4

Infant Death

Data Gathering

Case Review Team (CRT)

Community Action Team (CAT)

Interventions

Improved Maternal and Child Health Outcomes

Alabama Fetal and Infant Mortality Review Program

5

Pursuant to section Code of Ala. 1975, §§ 22-9A-21, 22-2-2(6)

Implemented January 21, 2009

Neonatal deaths

Statewide

Perinatal Regions

6

Factors Contributing to Infant Death

7

Low birth weightPrematurityMaternal pre-existing healthUnplanned pregnancyObesitySubstance Abuse

Key FIMR Concepts

8

Systematic evaluation of individual casesIdentification of a broad range of factorsInclusion of information not available through

routine quantitative methodsSentinel eventsAvoidance of preventable/non-preventable

classifications of deathsAvoidance of blameTwo-tiered process – analytic and action processFeedback mechanismMultidisciplinary involvement

FIMR Process

9

Helps communities prepare and deliver culturally appropriate interventions to improve service systems and resources for their multi-ethnic populations.

10

Thank You!

Questions?