Fetal and Infant Mortality Review
by Thomas M. Miller, MD
National Fetal and Infant Mortality Review Program
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Collaborative effortBegan in late 1980’sMore than 220 programs40 states, the District of Columbia, Puerto
Rico, and the Virgin Islands15 statewide programs
FIMR Goals
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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
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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
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Pursuant to section Code of Ala. 1975, §§ 22-9A-21, 22-2-2(6)
Implemented January 21, 2009
Neonatal deaths
Statewide
Perinatal Regions
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Factors Contributing to Infant Death
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Low birth weightPrematurityMaternal pre-existing healthUnplanned pregnancyObesitySubstance Abuse
Key FIMR Concepts
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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
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Helps communities prepare and deliver culturally appropriate interventions to improve service systems and resources for their multi-ethnic populations.
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Thank You!
Questions?
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