Dartmouth-Hitchcock’s Perinatal Addiction Treatment Program has received a $127,000, three-year grant from the March of Dimes New England Chapter to improve the quality and safety of care provided to pregnant women with identified substance use disorders. The grant will be used to develop and test an evidence-based toolkit for maternity care providers.
Substance abuse disorders are rampant in New Hampshire and the larger region and include many pregnant women who urgently need treatment. According to the Northern New England Perinatal Quality Improvement Network (NNEPQIN), perinatal opioid use is a growing public health problem regionally, reflecting the dramatic rise in heroin and other narcotic use among women of childbearing age in New England.
"Untreated opioid use disorders are associated with poor maternal and neonatal outcomes, including prematurity, infectious disease, and neonatal abstinence syndrome," said Daisy Goodman, an advance practice nurse with a specialty in midwifery who works closely with the women in the Perinatal Addiction Treatment Program.
The Dartmouth-Hitchcock Perinatal Addiction Program is a collaborative, multi-disciplinary program launched in 2013 to provide comprehensive care to pregnant and postpartum women with substance use disorders and their newborns. Since its inception, the program has demonstrated positive outcomes for its participants, including increased participation in prenatal care, term delivery, fewer newborns requiring treatment for neonatal abstinence syndrome, and increased patient satisfaction.
"The March of Dimes local chapters assess maternal and child health needs and then plan, fund and implement community programs," said Ed Doherty, Chapter Director of the New England March of Dimes. "Supporting this important project at Dartmouth-Hitchcock Medical Center in the area of perinatal addiction treatment aligns with the March of Dimes goal to support quality improvement initiatives related to substance use in pregnant women. With the incidences of Neonatal Abstinence Syndrome on the rise this is an urgent and necessary problem to address."
"Although treatment of substance use improves perinatal outcomes, significant variation exists in the care that is delivered," Goodman said. "Historically, communication between maternity care and addiction treatment providers has been limited, in part due to misunderstandings about federal privacy laws, and because no standard process for communication exists. This lack of coordination affects both the quality and safety of care and access to care is limited." NH currently ranks 49th of the 50 states in access to drug treatment.
To address the identified gap in quality and safety for this patient population, Goodman will serve as the investigative leader in developing the toolkit during the next three years. The goal is to facilitate the regional delivery of comprehensive services for pregnant women with substance use disorders. The toolkit addresses the challenges of coordinating care between maternity and addiction treatment providers, as well as between the in-patient and out-patient settings.
Recognizing that resources differ widely between practice contexts, the project will focus during the first year on exploring provider and patient-level barriers to providing comprehensive care, as well as current research supporting best practice. During the second year, the toolkit will be pilot tested at sites serving diverse populations, and in year three the toolkit will be distributed regionally.
"We anticipate improvement in both the consistency and quality delivered in the Dartmouth-Hitchcock service area," Goodman said. "The toolkit will combine a summary of best practice with materials to help health care providers in a variety of contexts improve care processes and outcomes for this vulnerable population."
DARTMOUTH-HITCHCOCK HEALTH (D-HH), New Hampshire’s only academic health system and the state’s largest private employer, serves a population of 1.9 million across Northern New England. D-H provides access to more than 2,400 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon, NH. DHMC was named in 2019 as the #1 hospital in New Hampshire by U.S. News & World Report, and recognized for high performance in 13 clinical specialties and procedures. Dartmouth-Hitchcock Health also includes the Norris Cotton Cancer Center, one of only 51 NCI-designated Comprehensive Cancer Centers in the nation; the Children's Hospital at Dartmouth-Hitchcock, the state’s only children’s hospital; affiliated member hospitals in Lebanon, Keene, and New London, NH, and Windsor, VT, and Visiting Nurse and Hospice for Vermont and New Hampshire; and 24 Dartmouth-Hitchcock clinics that provide ambulatory services across New Hampshire and Vermont. The D-H system trains nearly 400 residents and fellows annually, and performs world-class research, in partnership with the Geisel School of Medicine at Dartmouth and the White River Junction VA Medical Center in White River Junction, VT.
About the March of Dimes
The March of Dimes is the leading nonprofit organization for pregnancy and baby health. For more than 75 years, moms and babies have benefited from March of Dimes research, education, vaccines, and breakthroughs. Find out how you can help prevent premature birth and birth defects by joining March for Babies at marchforbabies.org. For the latest resources and information, visit marchofdimes.org or nacersano.org.