Hypertension Initiative Enrollment WisPQC Hypertension Initiative Enrollment Please complete this survey to enroll in the WisPQC Hypertension Initiative. Name of site*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Name* First Last Title or position*Email* We will use this email address for communication related to the initiative. You will be able to add additional contacts below.Do you want to add additional contacts?*YesNoAdditional contactsYou may enter names and email addresses for up to three additional contacts in the spaces below. If you would like to add others, please send an email to [email protected]Name First Last Email Do you wish to add another contact?YesNoName First Last Email Do you wish to add another contact?YesNoName First Last Email Measure SelectionUse this section to indicate interest in the measures. Selection of measures is non-binding.Measure 1: Maternal length of stay or documented outpatient follow-up*YesNoUnsureEnrolled hospitals will increase the percent of maternity patients with gestational hypertension or preeclampsia of any severity*, regardless of timing of onset, who have given birth at equal to or over 20 weeks completed gestation with post-delivery length of stay (LOS) greater than or equal to 72 hours in the hospital or documented evidence of follow-up by 10% each month of the initiative. *Includes eclampsia and HELLP syndrome. Measure 1: UnsurePlease explain.Measure 2: Consumer education*YesNoUnsureEnrolled hospitals will increase the percent of postpartum maternity patients greater or equal to 20 weeks completed gestation receiving education on the signs and symptoms of postpartum preeclampsia prior to hospital discharge by 10% each month of the initiative.Measure 2: UnsurePlease explain.Measure 3: NICU admission*YesNoUnsureMonitor percent of infants admitted to the NICU with maternal diagnosis of any type of hypertension or preeclampsia of any degree of severity* during pregnancy. * Includes eclampsia and HELLP syndrome. Measure 3: UnsurePlease explain.Measure 4: Low-dose aspirin (81 mg daily) with risk factors for preeclampsia*YesNoUnsureThe percent of maternity patients of greater than or equal to 20 weeks completed gestation with chronic hypertension, history of preeclampsia, multifetal gestation, type 1 or 2 diabetes, renal disease, and/or autoimmune disease and took antiplatelet therapy (aspirin) during pregnancy will increase 10% each month of the initiative.Measure 4: UnsurePlease explain.Measure 5: Appropriate medical management in under 60 minutes*YesNoUnsureThe percent of maternity patients with new onset severe range hypertension (systolic BP ≥ 160 mm Hg OR diastolic BP ≥ 110 mm Hg) who receive treatment within 60 minutes of confirmation* will increase 10% each month of the initiative. *Repeat BP within 15 minutes to confirm. Measure 5: UnsurePlease explain.Measure 6: Debriefs on all clinical situations involving new onset severe range hypertension*YesNoUnsureThe percent of clinical situations involving new onset severe range hypertension (systolic BP ≥ 160 mm Hg OR diastolic BP ≥ 110 mm Hg) that have documentation of a debrief* will increase 10% each month of the initiative. *See Kilpatrick SJ et al. Standardized Severe Maternal Morbidity Review: Rationale and Process. Obstet Gynecol. 2014; 124(4):361-365 for an example of a debriefing tool. Measure 6: UnsurePlease explain.Measure 7: Severe maternal morbidity*YesNoUnsureThe percent of maternity patients with gestational hypertension or preeclampsia* of any severity, regardless of timing of onset, who receive a transfusion with ≥ 4 units blood and/or are admitted to the ICU will decrease by 10% during the initiative. * Includes eclampsia and HELLP syndrome. *Sites will select the target based on an assessment of their baseline. Measure 7: UnsurePlease explain.Can we list your site on the WisPQC Web site for this initiative?*YesNoOne of the strengths of a perinatal collaborative is the opportunity to develop relationships with new stakeholders. WisPQC wants to promote those relationships by listing the sites involved in initiatives on its Web site.