Improving Maternal Care in Florida Through Levels of Maternal Care Verification

In response to increasing maternal morbidity and mortality, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal Fetal Medicine (SMFM) developed an Obstetrical Care Consensus on Levels of Maternal Care (LOMC) outlining four levels of care. This standardization reduces preventable morbidity and mortality by establishing hospital capabilities to ensure the provision of risk-appropriate care.

In 2020, Florida's Maternal Mortality Review Committee found that 68% of pregnancy-related deaths were preventable, with 22% attributed to system- and facility-level factors. Subsequent recommendations emphasized the need to strengthen adherence to ACOG guidelines and other protocols and care coordination.

The Florida Perinatal Quality Collaborative (FPQC) worked with ACOG District XII and The Joint Commission (TJC) to administer their Maternal Levels of Care Verification Program. The program involves an FPQC funding application, TJC application, TJC site visit, and FPQC evaluation.

FPQC provided support to applying hospitals through office hours, mentorship, technical assistance, the Florida LOMC Playbook, and a marketing toolkit for verified hospitals.

At the time of this publication, 41 Florida hospitals completed verification, with additional hospitals in progress. These hospitals account for 55% of Florida births. Through FPQC consultation, several hospitals learned they could verify at a different level than planned and adjusted their applications.

Florida's LOMC program demonstrates the utility of external review and objective verification standards to improve hospital readiness to provide optimal care. The comprehensive FPQC support process facilitates hospital preparation for a successful verification review.