The FIMR Project Shalae Harris, RN, BSN, MPA FIMR Coordinator/Chart Abstractor
The FIMR Project
Shalae Harris, RN, BSN, MPAFIMR Coordinator/Chart Abstractor
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
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)
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
Source: Heath, United States, 2009
6.7
5.0
4.7
3.8
3.8
3.8
2.8
2.6
0 1 2 3 4 5 6 7
United States
England and Wales
Australia
Germany
France
Spain
Sweden
Japan
Rate per 1,000 live birthsSource: Heath, United States, 2009
Source: Bureau of Epidemiology and Public Health Informatics, KDHE; National Center for Health Statistics, CDC
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)
The Causes of Infant Mortality
Low birth weight
Prematurity
Birth Defects
SIDS
Disparities in health care access
Disparities in living conditions
Relational issues
Stress
Environmental conditions
Physical Social/Environmental
23%
15%
17%11%
28%
6%
Birth Defects (Congenital Anomalies)SIDSShort gest./low birth weightMaternal preg. complicationsOtherExternal causes of mortality
Source: Bureau of Epidemiology and Public Health Informatics, KDHE
FIMR
Fetal Infant Mortality Review
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
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.
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
The FIMR Process
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
Notification of death
Case records abstraction
Maternal/Family interview
Case summary
Changes in community systems
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 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
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
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
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
Educate
Bring Awareness
Support
Document
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
Shalae Harris, RN, BSN, MPAFIMR Coordinator/Chart AbstractorSedgwick County Health DepartmentHealthy Babies434 N. Oliver, Suite 110Wichita, KS [email protected]