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Sedgwick County Fetal and Infant Mortality Review (FIMR)

Sedgwick County Fetal and Infant Mortality Review (FIMR). The FIMR Project. Shalae Harris, RN, BSN, MPA FIMR Coordinator/Chart Abstractor. Sedgwick County FIMR is a Project of…. Healthy Babies Sedgwick County Health Department Central Plains Regional Health Care Foundation

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Sedgwick County Fetal and Infant Mortality Review (FIMR)

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  1. Sedgwick County Fetal and Infant Mortality Review (FIMR) The FIMR Project Shalae Harris, RN, BSN, MPA FIMR Coordinator/Chart Abstractor

  2. Sedgwick County FIMR is aProject of…. • Healthy Babies • Sedgwick County Health Department • Central Plains Regional Health Care Foundation • Kansas Department of Health and Environment • Bureau of Health Informatics • Bureau of Local and Rural Health • SIDS Network of Kansas • Medical Society of Sedgwick County • KUMC– Wichita, Office of Research • Kansas City Healthy Start

  3. The FIMR Project • Mahatma Gandhi said, “a nation’s greatness is measured by how it treats its weakest members”. • Our littlest members are key indicators of a community’s well being • Infant health is a measure of community well-being. (NFIMR website, 2001)

  4. What is Infant Mortality? • Death of a child under one year of age • Infant death is measured by the infant mortality rate • Infant mortality rate (IMR) is the number of deaths for babies under one year of age in a given year for every 1,000 live births in the same year • The IMR is measured in every country and US state

  5. US World Ranking for IMR Source: Heath, United States, 2009

  6. Infant Mortality Rates Worldwide(2006) Source: Heath, United States, 2009

  7. Infant Mortality TrendsKS and US (1992-2008) Source: Bureau of Epidemiology and Public Health Informatics, KDHE; National Center for Health Statistics, CDC

  8. IMR in Kansas • Kansas ranks 29th in the nation (2007) • Kansas’ rate was 17% higher than US rate (2007) • Kansas ranks #1 in the nation for black infant mortality (2007)

  9. Infant Mortality Rates (IMR) for Sedgwick County, Wichita, KS, broken down by African American and All Races, as compared to IMR for All Races in Sedgwick County, Kansas and United States, based on three-year rolling averages from 2000 thru 2009

  10. The Causes of Infant Mortality Physical Social/Environmental • Low birth weight • Prematurity • Birth Defects • SIDS • Disparities in health care access • Disparities in living conditions • Relational issues • Stress • Environmental conditions

  11. Causes of Infant Death in Kansas (2005-2009) Source: Bureau of Epidemiology and Public Health Informatics, KDHE

  12. What is being done to reduce the infant mortality rate?

  13. FIMR Fetal Infant Mortality Review

  14. What is FIMR? • A collaborative effort of community, county, state, and federal resources to reduce the IMR • An action oriented process that continually assesses, monitors, and works to improve community resources and service delivery systems

  15. Sedgwick County FIMR Project Goals The FIMR project is designed to enhance the health and well being of women, infants, and families by improving the community resources and service delivery systems available to them.

  16. FIMR is not…. • About fault finding or assigning blame for death of the infant • A comprehensive quality assurance program for hospitals or clinics • About conducting original research on the causes of infant death

  17. The FIMR Process

  18. What Does a FIMR Do? • Data Gathering • Reviews de-identified cases • Identifies interventions to address factors that were associated with the infant death • Implements community based interventions and/or policies for change • Assesses the progress of these interventions and their long term impact on reducing infant mortality

  19. The FIMR process: Data Gathering • Notification of death • Case records abstraction • Maternal/Family interview • Case summary • Changes in community systems

  20. The FIMR Process: Case Review Team (CRT) • Reviews case data from medical records and family interviews • Identifies trends and gaps in services • Makes recommendations to the CAT for systemic community change

  21. 2010 FIMR CRT • 21 members met July 2010-June 2011 • Representing over 20 organizations • 22 cases reviewed • 25 Cases with attempted interviews • 10 Cases with completed interviews 2010 recommendations surround 3 themes: • Education • Connection • Access

  22. The FIMR Process: Community Action Team (CAT) • Develops community interventions based on recommendations received • Utilizes existing community resources to implement intervention strategies • Addresses the need for resources and services not currently available

  23. 2010 FIMR CAT • CAT core team is 15 members • Past year met 6 times • Representing 6 organizations • 2 task forces focusing on FIMR CRT education recommendations: • Maternal Tobacco Cessation CAT Task Force • AHBBY CAT Task Force

  24. Lessons Learned from FIMR Projects • Infant health is a measure of community well-being. • FIMR is a community coalition. • FIMR programs engage a diverse membership. • FIMR programs thrive on effective group process. • Action is key to FIMR. • FIMR programs take on a wide range of community action. • FIMR programs build on existing community assets. • The FIMR process is a journey, not a destination. • FIMR programs use population based data. • FIMR programs communicate to the larger community. • FIMR programs recognize and celebrate the work of their team members. NFIMR, National Fetal Infant Mortality Review, ACOG website

  25. What Can You Do? • Educate • Bring Awareness • Support • Document

  26. Acknowledgments • Dr. Dennis Cooley, Chairperson, Kansas Blue Ribbon Panel on Infant Mortality “Kansas Infant Mortality” PowerPoint, September 2, 2010. • Dr. Diane Helentjaris, Virginia Department of Health, “The Silent Epidemic: Uniting to Reduce Infant Mortality” PowerPoint, September 2, 2010. • Kansas Department of Health and Environment, Bureau of Family Health, Bureau of Public Health Informatics. • Kansas Department of Health and Environment, Center for Health Disparities • Kansas Blue Ribbon Panel on Infant Mortality ,Infant Mortality Factsheet and FIMR concept paper. • TFIMR, Tulsa Fetal & Infant Mortality Review Project, “An Introduction for Prospective Members of the Case Review Team (CRT), PowerPoint, 1998. • NFIMR, National Fetal Infant Mortality Review, ACOG website

  27. Sedgwick County Contact Shalae Harris, RN, BSN, MPA FIMR Coordinator/Chart Abstractor Sedgwick County Health Department Healthy Babies 434 N. Oliver, Suite 110 Wichita, KS 67208 316-660-0984 sharris@sedgwick.gov

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