OB COAP is a collaborative quality improvement program helping obstetrical care providers deliver optimum care to the childbearing people and the babies they take care of.
Following a long-standing successful model of clinician-led, data-driven quality improvement established under the Foundation for Health Care Quality, OB COAP utilizes clinical data from the medical record to evaluate the care given to pregnant persons during labor, delivery and the postpartum period as the basis for exploring actionable and sustainable improvements.
OB COAP is open to any site delivering babies. Current participants include hospitals of all sizes and neonatal/maternal level of care in urban, suburban and rural locations, as well as community births planned in home or birth centers. The data collected allows for analysis of provider-specific decisions during labor, delivery and postpartum; the impact of factors such as patient risk, gynecological history, clinician type and environment on outcomes; and balancing measures that evaluate both the intended and unintended effects of changes in practice.
The Foundation for Health Care Quality is a non-profit organization and participation in OB COAP is protected as a Certified Quality Improvement Program, making this a safe and neutral place for members to work on ensuring they maintain the highest quality of care for everyone they care for.
Prophylactic Use of Low Dose Aspirin to Prevent Preterm Preeclampsia
The United States Preventive Services Task Force (USPSTF) recommends the use of low-dose aspirin in prenatal patients at moderate to high risk for developing preterm preeclampsia. Understanding who is at risk, when and how much to prescribe, and barriers to follow through are critical components to ensuring that as many pregnant people as possible will benefit from this best practice. OB COAP has been monitoring the rate at which the recommendation to take low dose aspirin is documented in the medical records of prenatal patients at high risk for preterm preeclampsia. While the rate has been slowly improving over the past year, it is much lower than it should be and there remains a great deal of variability across sites and across individual prenatal practitioners.
In mid-November, OB COAP hosted an educational webinar focused on a review of the literature, examination of the current aggregate metrics from our participating sites, and a discussion about communicating with patients about these recommendations. You may view this webinar presented by Dr. Patience Jaman and Dr. Angela Chien here: OB COAP Webinar – Prophylactic Use of Low Low Dose Aspirin to Prevent Preeclampsia.
We encourage you to review, download and distribute this prophylactic low dose aspirin decision aid which outlines the USPSTF recommendations.
These resources can complement the state-level work on blue bands. And if your site is a member of OB COAP, you can monitor your progress with this quality improvement initiative at the site and practitioner-level. If you are not familiar with these reports, contact us to find out how to access them!
Since 2018, the FHCQ has been working with midwifery leaders to build a comprehensive data repository that will enable ALL community-based midwives in Washington state and beyond, to collect their data alongside hospital data for the purpose of both quality improvement and research.
OB COAP participants and researchers are continually examining data and working on QI efforts