NHS FPX 8002 Assessment 1 Demonstrating Effective Leadership NHS-FPX 8002 Collaboration, Communication, and Case Analysis for Doctoral Learners Demonstrating Effective Leadership

The United States of America faces one of the highest maternal morbidity and mortality rates among developed nations worldwide (Johnson, 2022). According to the Centers for Disease Control (CDC), 2021 marked one of the worst years for maternal deaths in U.S. history, with a 40% increase between 2020 and 2021 (Hoyert, 2021). Particularly alarming is the significant racial and ethnic disparity in maternal outcomes, with Black women being three to four times more likely to experience pregnancy-related deaths compared to white women (CDC, 2019).

In response to this crisis, the CDC established the Perinatal Quality Collaboratives (PQCs), a collaboration between federal and state governments aimed at improving healthcare processes to prevent maternal deaths and reduce racial disparities. However, effective local implementation requires a leadership coalition. This paper focuses on strategies to enhance Black maternal health in Palm Beach County, Florida, through the formation of a collaborative coalition, analyzing contributing factors, and proposing interventions.

Contributing Factors

The maternal death rate in the United States rose by nearly 20% in 2020, reaching the highest level among economically developed countries (Johnson, 2022). Maternal mortality, as defined by the CDC, includes deaths of women during pregnancy or within 42 days of termination, excluding accidental or incidental causes (CDC, 2019). Leading medical causes of maternal mortality in the U.S. include blood clots in the lung, hypertension, and blood loss (Johnson, 2022). Disturbingly, African American (AA) mothers face three to four times the risk of pregnancy-related death compared to white or Hispanic mothers (Collier & Molina, 2017). Southern states, particularly Florida, exhibit the highest maternal mortality rates and interval rate increases (Synder et al., 2020).

Regional variations highlight the lowest per-population healthcare provider ratios in the South, especially for certified nurse-midwives and obstetricians (Synder et al., 2020). Longitudinal studies emphasize higher maternal morbidity rates among AA mothers in the southern United States (Kramer et al., 2023). Despite Florida ranking 32nd in maternal mortality rates among U.S. states, racial disparities persist (Bravender, 2020). Leading causes of maternal death among Black women, including cardiomyopathy, eclampsia, and preeclampsia, occur at rates five times higher than in white women (MacDorman et al., 2021).

Disparities persist even when controlling for factors like education and socioeconomic status (Petersen et al., 2019). Black women often report poor continuity of care, communication gaps, and perceived lack of attentiveness in their maternal experiences with the U.S. healthcare system (Wang et al., 2021). Maternal deaths among Black women, often preventable, result from issues such as cardiomyopathy with noticeable symptoms (MacDorman et al., 2021). Implicit bias, lack of access to quality healthcare, inadequate health insurance, and racism contribute to health disparities (Bravender, 2020).

Coalition to Address Maternal Morbidity

A coalition in Palm Beach County, Florida, consisting of healthcare professionals and community organizations, aims to analyze factors contributing to poor maternal outcomes for African-American women. The five-member coalition comprises an Obstetrician-Gynecologist, Certified Nurse Midwife, Labor & Delivery Registered Nurse, Doula, and a representative from the Healthy Mothers Healthy Babies Coalition of Palm Beach County, Inc. Their diverse expertise contributes to analyzing components leading to high rates of Black maternal deaths and implementing evidence-based strategies. The coalition focuses on improving patient safety, healthcare quality, and reducing racial disparities.

Issues Affecting Collaboration

Several potential issues may impact interprofessional collaboration, including communication gaps, time constraints, undefined roles and responsibilities, biases, differences of opinion, and ineffective leadership. Hierarchy conflicts may arise among team members, such as obstetricians and certified nurse midwives. Autonomy is crucial but could become a barrier without compromise, trust, or respect for all team members.

Strategies to Optimize Collaboration

Effective collaboration is essential for developing strategies to reduce health disparities and enhance patient safety. A shared mission, clearly defined roles and responsibilities, good communication, and a collaborative approach with other organizations addressing similar issues are crucial elements for success (Downey et al., 2018). The coalition’s mission to ensure optimal birth outcomes for AA mothers in Palm Beach County, Florida, requires shared values and responsibili