At a glance
A logic model shows the relationship between a program’s activities and its intended effects. Although maternal mortality review committees (MMRCs) differ by state, the logic model represents general inputs, activities, and outcomes of an ideal, fully functional MMRC. The logic model is adaptable to the context of individual state or city MMRCs.
Introduction
A logic model is a road map. It presents the shared relationships among the resources, activities, outputs, and outcomes of your program. In this logic model, a key condition for MMRCs to move from process improvements to successful long-term outcomes is that MMRC recommendations are part of a cycle of continuous quality improvement for health systems. There are assumptions and contextual factors that are also important for success.
Resource
Process
Inputs
Activities
Outputs
- Legislative authority and protections
– Authority to access required data
– Confidentiality
– Immunity for committee members from subpoena - Leadership buy-in
- Staff
- Funding
- Defined scope and explicit protocols
- Data
– Vital records
– Medical records
– Social Service Records - Defined stakeholders and membership
– With status or authority to implement recommendations within their organizations
– Broad representation
- Secure any missing inputs (from previous column)
- Periodically recruit and train committee members
- Identify cases and select cases for abstraction
- Abstract cases and produce case summary
- Convene committee meeting, review cases, and make key committee decisions
- Disseminate recommendations
- Identify implementation resources
- Fully functional and sustainable MMRC
- Robust, accurate data
- Health surveillance and data analysis build evidence base
- Recommendations
- Reports and presentations
- Campaigns, trainings, and initiatives
Outcomes
Short
Intermediate
Long
- Awareness of the existence and recommendations of the MMRC among the public, clinicians, and policy makers
- Adoption of policy changes by health systems
- Implementations of data driven recommendations e.g. evidence based practices, screenings, and patient education by providers, etc.
- Widespread adoption of patient safety bundles and/ or policies that reflect the highest standard of care
- Access to holistic care during pregnancy and postpartum period e.g. prenatal, diabetes, mental health, and substance use disorder care, etc.
- Coordination of care across providers
- Elimination of disparities in pregnancy-related deaths
- Elimination of preventable maternal death
- Reduction in maternal morbidity
- Improvement in population health for women of reproductive age including reductions in hypertension, substance use, and other chronic diseases
Assumptions
- State has a task force, perinatal quality collaborative, or other infrastructure to implement MMRC recommendations.
- State has a funded, functioning system for conducting quality autopsies.
Contextual Factors
- Geography.
- Political will and support.