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 67208316-660-0984sharris@sedgwick.gov