Please see information on the Perinatal Behavioral Health Report under the “Behavioral Health” section.
Reproductive Health
Hysterectomy
Guideline title: Hysterectomy Report and Guidelines
Publication Status: Active
Date of publication: 2018
Date of last evidence search: 2018
Scope: Assessment and medical management; uterine sparing procedures; surgical procedure; follow-up care; enhanced recovery after surgery protocol; use of a minimally invasive approach.
Methods: Current guidelines and literature review and expert consensus
Description: The workgroup’s goal is to promote appropriate use of hysterectomy, including pre-surgical counseling and evaluation, while recognizing individual variation based on clinical opinion and patient preference. Workgroup members developed the guidelines to encourage clinicians to review guidelines with patients prior to hysterectomy to reduce unnecessary or inappropriate hysterectomies.
Supporting Material:
Letter from the Health Care Authority Accepting Hysterectomy Recommendations
Hysterectomy Charter and Roster
To support health system improvement the Bree Collaborative has created score cards that are designed to help measure progress on the implementation of our guidelines. These were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)
To use our score cards, find the audience type, or types, that is closest to your organization or area of improvement work and download the document. There may be more than one “audience” type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.
Score cards are also aligned with the Bree Collaboratives’ self-report data collection efforts. Organizations are not required to report, however anyone can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards.
Health Systems
Coming Soon
Health Plans
Health Care Purchasers
Washington State Health Care Authority
| Name | Title | Organization |
| Pat Kulpa, MD, MBA | Medical Director | Regence BlueShield |
| Sharon Kwan, MD, MS | Interventional Radiologist | University of Washington Medical Center |
| John Lenihan, MD | Medical Director of Robotics and Minimally Invasive Surgery | MultiCare Health System |
| Jennie Mao, MD | Clinical Assistant Professor, Department of Obstetrics and Gynecology | University of Washington Medical Center |
| Rachelle McCarty, MPH | Patient Advocate | |
| Sarah Prager, MD | Chair | Washington State Section of ACOG |
| Kevin Pieper, MD | Chief, Women’s and Children’s | Providence Regional Medical Center Everett |
| Kristin Riley, MD, FACOG | Assistant Professor, Department of Obstetrics and Gynecology | University of Washington Medical Center |
| Jeanne Rupert, DO, PhD (Chair) | Family Physician | One Medical |
| Anita Showalter, DO, FACOOG | Associate Professor and Chair, Women’s Health | Pacific Northwest University of Health Sciences |
| Susan Warwick, MD | Obstetrics and Gynecology | Kaiser Permanente |
Obstetrics Care
Guideline title: Obstetrics Care Report and Guideline
Publication Status: Needs minor revisions – to be scheduled
Date of publication: August 2012
Date of last evidence search: 2012
Scope: Elective deliveries, Elective inductions of labor, Primary c-sections
Methods: Current guidelines and literature review and expert consensus
Description: This report aims to to accelerate quality improvement in three areas of OB, which, in turn, will improve the safety, quality, and affordability of patient care for mothers and infants, and decrease costs for the entire community.
Supporting Material:
To support health system improvement the Bree Collaborative has created score cards that are designed to help measure progress on the implementation of our guidelines. These were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)
To use our score cards, find the audience type, or types, that is closest to your organization or area of improvement work and download the document. There may be more than one “audience” type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.
Score cards are also aligned with the Bree Collaboratives’ self-report data collection efforts. Organizations are not required to report, however anyone can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards.
Score cards for the Obstetrics Care report will be developed during the upcoming guidelines revision process.
Delivery Sites and Health Systems
Health Plans
Washington State Health Care Authority
Health Care Purchasers
| Member | Title | Organization |
|---|---|---|
| Theresa Helle | Manager, Health Care Quality & Efficiency Initiatives | The Boeing Company |
| Ellen Kauffman, MD | OB-COAP Medical Director | Foundation for Health Care Quality |
| Robert Mecklenburg, MD | Medical Director, Center for Health Care Solutions | Virginia Mason Medical Center |
| Carl Olden, MD (Chair) | Family Physician | Pacific Crest Family Medicine, Yakima |
| Mary Kay O’Neill, MD, MBA | Executive Medical Director | Regence Blue Shield |
| Dale Reisner, MD | Obstetrician/Gynecologist | Swedish Hospital Perinatologist |
| Terry Rogers, MD | Chief Executive Officer | Foundation for Health Care Quality |
| Roger Rowles, MD | Obstetrician/Gynecologist | Yakima Memorial OB-GYN |
Perinatal Bundled Payment Model
Guideline title: Perinatal Bundled Payment Model Report and Guidelines
Publication Status: Needs minor revisions – to be secheduled
Date of publication: First published 2019, Revision in 2021
Date of last evidence search: 2021
Scope: This report presents a payment model that includes prenatal care, labor and delivery, postpartum care, and pediatric care along with clinical components for internal quality tracking and performance metrics.
Methods: Current guidelines and literature review and expert consensus
Description: The work group developed a clinical pathway supported by an episode-based payment building on existing perinatal work within Washington State prioritizing health equity, high-quality, and evidence based perinatal and pediatric care.
Resources and Tools
Appendix D: Episode and Perinatal Guideline Systematic Review Search Results
Appendix F: Included Services and Coding
Appendix H: Behavioral Health Treatment
Appendix I: Opioid Use Disorder Treatment
Appendix J: Pediatric – Obstetrics Information Exchange
Appendix K: Postpartum 4-12 Per-Member-Per-Month
California Maternal Quality Care Collaborative Cardiovascular Disease
in Pregnancy and Postpartum Toolkit
Washington State Perinatal Collaborative (WSPC)
ACOG Optimizing Postpartum Care
AAP Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice
Purchaser Business Group on Health
To support health system improvement the Bree Collaborative has created score cards that are designed to help measure progress on the implementation of our guidelines. These were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)
To use our score cards, find the audience type, or types, that is closest to your organization or area of improvement work and download the document. There may be more than one “audience” type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.
Score cards are also aligned with the Bree Collaboratives’ self-report data collection efforts. Organizations are not required to report, however anyone can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards.
Score cards for the Perinatal Payment Bundle and guidelines will be developed during the upcoming guidelines revision process.
Delivery Sites and Health Systems
Health Plans
Washington State Health Care Authority
Health Care Purchasers
| Member | Title | Organization |
|---|---|---|
| Carl Olden, MD (Chair) | Family Physician | Pacific Crest Family Medicine |
| Andrew Castrodale, MD | Family Physician | Coulee Medical Center |
| Angela Chien, MD | Obstetrics and Gynecology | Evergreen Health |
| Neva Gerke, LM | President | Midwives Association of Washington |
| Molly Firth, MPH | Patient Advocate | |
| Lisa Humes-Schulz, MPA/ Lisa Pepperdine, MD |
Director of Strategic Initiatives/ Director of Clinical Services | Planned Parenthood of the Great Northwest and Hawaiian Islands |
| Rita Hsu, MD, FACOG | Obstetrics and Gynecology | Confluence Health |
| Dale Reisner, MD | Obstetrics and Gynecology | Swedish Medical Center |
| Janine Reisinger, MPH | Director, Maternal-Infant Health Initiatives | Washington State Hospital Association |
| Mark Schemmel, MD | Obstetrics and Gynecology | Spokane Obstetrics and Gynecology, Providence Health and Services |
| Vivienne Souter, MD | Research Director | Obstetrics Clinical Outcomes Assessment Program |
| Judy Zerzan, MD | Chief Medical Officer | Washington State Health Care Authority |
Previous Meeting Materials
Reproductive and Sexual Health
Guideline title: Reproductive and Sexual Health Report and Guidelines
Publication Status: Active
Date of publication: 2020
Date of last evidence search: 2020
Scope: Cultural humility; access; person-centered care; appropriate care
Methods: Current guidelines and literature review and expert consensus
Description: These guidelines aim to improve quality, equity, and cultural appropriateness of reproductive and sexual healthcare services across the lifespan in Washington State. The workgroup has expanded on the populations identified in Senate Bill 5602 (2019) to focus on improvement of clinical services for those who are Black, indigenous, people of color, immigrants or refugees, have experienced violence including human trafficking, people with disabilities, and Lesbian, Gay, Bisexual, Transgender, and/or Questioning or Queer (LGBTQ+).
In 2023 the Bree Collaborative introduced a new process of metrics and measures identification that has been embedded into the guideline development process. A framework for evaluation has been created and recommended metrics have been identified by audience (below).
Delivery Sites and Health Systems
Health System Evaluation Score Card
Health Plans
Health Plan Evaluation Score Card
Washington State Health Care Authority
Health Care Purchasers
| Name | Title | Organization |
| Charissa Fotinos, MD (Chair) | Deputy Chief Medical Officer | Washington State Health Care Authority |
| Trish Anderson, MBA | Senior Director, Safety and Quality | Washington State Hospital Association |
| Janet Cady, ARNP | Medical Director, School Based Program | Neighborcare |
| Angela Chien, MD | Obstetrics and Gynecology | Evergreen Health |
| Paul Dillon/Lili Navarrete | Latinx Outreach & Organizing Program | Planned Parenthood of Greater Washington and North Idaho |
| Colin D. Fields, MD | Chief, Gender Health Program | Kaiser Permanente Washington |
| Leo Gaeta | Vice President of Programs |
The Columbia Basin Health Association
|
| Cynthia Harris, PhD | Family Planning Program Manager | Department of Health |
| Leigh Hofheimer | Program Coordinator | Washington State Coalition Against Domestic Violence |
| Rita Hsu, MD, FACOG | Obstetrics and Gynecology | Confluence Health |
| Heather Maisen, MPH, MSW | Family Planning Program Manager | Public Health – Seattle & King County |
| Adrianne Moore | Deputy Director of Quality Improvement | Upstream |
| Ivanova Smith | Patient Advocate | UW LEND Faculty |
| Mandy Weeks-Green | Senior Health Policy Analyst | Officer of the Insurance Commissioner |
| Catherine West, JD | Staff Attorney | Legal Voice (formerly Northwest Women’s Law Center) |
| Giselle Zapata-García | Co-Director | Latinos Promoting Good Health (also Latinx Health Board, Executive Committee Co-Chair) |
Previous Meeting Materials
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