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IMPLICIT Network

IMPLICIT Network

Innovations for Maternal and PerinataL Care ImprovemenT

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    • About IMPLICIT
    • Where We Work
    • Meet the Team
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    • Interconception Care – ICC
    • 4th Trimester – 4TM
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Committees

  • Health Equity
  • Health Equity

    The Health Equity Committee facilitates projects within the IMPLICIT Network to further explore inequities in healthcare.

    Current Projects

    Patient needs assessment
    Objective: understand patient needs in the postpartum period, with input from patients, providers, and clinical staff (MAs, nurses)

    Site partnership survey
    Objective: identify and describe existing community partnerships at Network sites and use this information to create a Community Partnership Toolkit

    Inclusive language guidance
    Objective: Keep equity at the forefront of our communication and acknowledge gender diversity of postpartum parents

    Letter of support for specific legislation that improves the health and wellbeing of moms/birthing people and infants
    Objective: Have language available to support local/state/federal legislation that would improve the health and wellbeing of moms/birthing people and infants

    Educational social media series
    Objective: Increase presence on social media and be a source of educational information on topics related to postpartum/prenatal health and current events

  • Data Review
  • Data Review

    The Data Review Committee works to improve and help facilitate data collection, uploading, extraction, and reporting for the IMPLICIT Network. Review data for discrepancy and error, (data strategy). Utilize data for academic purposes, quality improvement and publications. Data use and governance (includes uploading data etc.)

    Network data presentations and engagement
    • Data presentation

    Site data
    • Support projects to look at data related questions
    • Help troubleshoot site data issue
    • Quality improvement support

    EHR mapping and integration of ICC and 4TM
    • Standardizations of smart data elements with smartforms and smarttext for EPIC
    • Creation of national EPIC builds for ICC and 4TM
    • Support in EHR builds in AllScripts and NextGen

    R Report
    • Maintain ICC and 4TM data reports
    • Recommend additions and edits to update reports (inclusive language, addition of behavior change, stratification of risk by maternal demographics, etc.)
    • Create standard data definitions
    • Support creation of ad hoc reports for special projects

    Network REDCap Database
    • Manage access and data entry
    • ICC (Phase 1, Phase 2, Phase 3)
    • 4TM (Phase 1, Phase 2, Outcomes Study)
    • Create surveys for projects

    Interconception Care (ICC)
    • Lead phase changes (Phase 1 to Phase 2 to Phase 3)
    • Behavior change
    • Stratification of risk by maternal demographics
    • Support toolkit creation and updates
    • Standard data definitions

    4th Trimester (4TM)
    • Lead Phase 1 to Phase 2 recommendations and edits
    • Support updates to questionnaires
    • Support toolkit creation
    • Standard data definitions

    PDSA Cycles
    • Lead Network wide PDSA cycles and QI initiatives
    • Maternal Demographics PDSA
    • Patient centered contraception counseling PDSA

  • Scholarly Activity
  • Scholarly Activity

    The Scholarly Activity Committee leads initiatives to promote broad and equitable participation in scholarly work within the IMPLICIT Network. The IMPLICIT Network has published 10 papers on our innovative care models and presented at conferences including FMEC, STFM, NAPCRG, AAP, and many more. 

    ICC Publications

    Is this normal?
    Authors: Brianna Moyer, MD
    Interconception Care and Safe Sleep: Adapting the IMPLICIT Toolkit for Pediatrics
    Authors: Emily Scott, MD, Corresponding Author; Kara Casavan, BS; Nancy Swigonski, MD, MPH, MBA
    Interconception Care for Mothers at Well Child Visits After Implementation of the IMPLICIT Model
    Authors: Daniel Frayne, Phillip Hughes, Brunilda Lugo, Kathy Foley, Stephanie Rosener, Wendy B. Barr, Scott A. Davis, Heidi Knoll, Kayla Krajick & Ian M. Bennett
    Interventions to Increase Multivitamin Use Among Women in the Interconception Period: An IMPLICIT Network Study
    Authors: Mario P. DeMarco, Maha Shafqat, Michael A. Horst, Sukanya Srinivasan, Daniel J. Frayne, Lisa Schlar & Wendy Brooks Barr
    Optimizing Interconception Care: Rationale for IMPLICIT Model
    Authors: Scott Hartman, Elizabeth Brown, David Holub, Michael Horst, and Elizabeth Loomis
    Clinician and Staff Perceptions of Barriers to Providing Contraception in Primary Care
    Authors: Lauren Cowen | Scott G. Hartman, MD | Elizabeth Loomis, MD | Sukanya Srinivasan, MD, MPH | Christina Gasbarro, MD | Jocelyn Young, DO
    Delivering Interconception Care During Well-Child Visits: An IMPLICIT Network Study 
    Authors: Sukanya Srinivasan, Lisa Schlar, Stephanie E Rosener, Daniel J Frayne, Scott G Hartman, Michael A Horst, Jessica L Brubach, Stephen Ratcliffe
    Interconception Care for Mothers During Well-Child Visits With Family Physicians: An IMPLICIT Network Study
    Authors: Stephanie E Rosener, Wendy B Barr, Daniel J Frayne, Joshua H Barash, Megan E Gross, Ian M Bennett
    Improving maternal care with a continuous quality improvement strategy: A report from the Interventions to Minimize Preterm and Low Birth Weight Infants through Continuous Improvement Techniques (IMPLICIT) Network
    Authors: Ian M Bennett, Andrew Coco, Janice Anderson, Michael Horst, Angela S Gambler, Wendy Brooks Barr, Stephen Ratcliffe
    Efficiency of a two-item pre-screen to reduce the burden of depression screening in pregnancy and postpartum: an IMPLICIT network study
    Authors: Ian M Bennett, Andrew Coco, James C Coyne, Alex J Mitchell, James Nicholson, Ellen Johnson, Michael Horst, Stephen Ratcliffe

    4TM Publications

    IMPLICIT Network: The 4th Trimester Program
    Redefining Postpartum Care through an Innovative Model
    Perinatal Mental Health Anxiety and OCD 
    Presented by: Priya Gopalan, MD, FACLP 01/29/2025
    Pregnancy and Domestic Violence: Supporting Patients who Experience Domestic Violence
    Presented by Mae Reale 11/19/2024
    The Impact of Doula Care on Pregnancy, Delivery and Postpartum
    Presented by: Dr. Sharee Livingston and Ashlee Heyward 11/6/2023
    Opioid Use Disorder in Pregnancy
    Presented by Caroline LaFave 11/16/2022
    The 4th Trimester Model: A new approach to improving perinatal care
    Authors: Amundam Mancho, MPH; Sara Peterson, BS; Lauren Cowen, MD; Alexandria Snow, MD; Rachel Bian, MD; Elizabeth Brown, MD; Dawn Pruett, MD and Scott Hartman, MD
    Fourth Trimester Care: Timely Intervention for Postpartum Needs
    Authors: Brianna Moyer, M.D.

    ABFM Organizational Performance Improvement (PI) Project

    What is an organizational PI?
    Designed for organizations that support physicians in quality improvement efforts. Allows for approval for Organizational PI activities that will provide certification credit for any physician who is meaningfully participating, simply through attestation from the organizational sponsor.

    What is the project?
    Interconception Care (ICC) screening rates at Well Child Visits have declined by nearly 15% over the last 2 years, leading to decreased screening and interventions for maternal health risk factors. From January of 2022 to December of 2024, ICC was being done at 66% of Well Child Visits at participating IMPLICIT Network sites. Though our most recent ICC data shows that ICC is completed when mothers/birthing people (M/BP) are marked present 86.5% of the time, we assume there are WCVs where M/BP are present but not documented or screened, leading us to believe this rate may be lower than it seems.

    Project Aim
    Improve Interconception Care (ICC) screening and intervention rates at well child visits (WCVs) at IMPLICIT Network sites

    How can I use this for my PI requirement?
    Interested providers can find this project listed in the ABFM catalog under “IMPLICIT ICC QI Cycle.”

    Both members and non members of the IMPLICIT Network may participate. For sites that are not currently IMPLICIT Network members there is a participation fee of $250.

    Please complete this registration form (also found on the ABFM website): https://redcap.link/swn7xvqp

    A member of the IMPLICIT Network staff will reach out to you to assist in starting your project.


    Conference Submission Tables

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    Preeclampsia is a hypertensive disorder that is a Preeclampsia is a hypertensive disorder that is a complication of pregnancy. It is characterized by high blood pressure and often the presence of protein in the urine. If left untreated, it can lead to serious complications for the mother/birthing person and baby. 

Low-dose aspirin (LDA), taken daily during pregnancy, can prevent or delay the onset of preeclampsia. If a mother/birthing person has risk factors for preeclampsia it is recommended, after consultation with the patient's provider, that daily LDA supplementation begins late in the first trimester. 

For providers, the Hypertension in Pregnancy Change Package (HPCP) can be utilized to put more efficient and effective systems in place to care for birthing people with hypertension in pregnancy. The HPCP outlines the evidence and indications of LDA use in pregnancy to prevent preeclampsia. 

#IMPLICITNetwork #HypertensiveDisorders #Preeclampsia #LowDoseAspirin
    Every mother/birthing person should have access to Every mother/birthing person should have access to comprehensive and patient centered family planning.

IMPLICIT Interconception Care (ICC) screens mothers/birthing people (MBPs) for four risk factors, including family planning, at their child’s Well Child Visits from 0-24 months. ICC initiates conversations about family planning, connects MBPs to care to discuss options, and/or even provides birth control at that visit.

IMPLICIT 4th Trimester (4TM) promotes patient centered contraception counseling across the prenatal and postpartum time periods. Providers review options and make a plan with the MBP to choose a contraception method that aligns with the MBP’s values and preferences.

Identifying family planning needs, providing interventions, and connecting families to care promotes not only healthier future pregnancies (if desired), but also a healthier mother/birthing person, child, and family. 

#IMPLICITNetwork #FamilyPlanning #Contraception #PatientCenteredContraceptionCounseling
    Providing professional development opportunities, Providing professional development opportunities, such as research opportunities and quality improvement projects, is at the cornerstone of the work the IMPLICIT Network seeks to provide to current and future physicians. 

This month, we will be highlighting student and residents who have partnered with the Network to conduct research projects utilizing IMPLICIT data. 

Today we are highlighting Anisha Willis! Anisha is a current undergraduate student at the University of Pennsylvania. She will be conducting a project focused on the effects of prenatal biomedical risks and intrapartum complications on mood disorders identified at the postpartum visit.

If you are a current student or resident interested in working with the IMPLICIT Network, please feel free to reach out to us! 

#IMPLICITNetwork #4thtrimester #research
    August is recognized as National Breastfeeding Mon August is recognized as National Breastfeeding Month!

Breastfeeding offers important benefits for both babies and birthing people. It helps protect against diseases, supports the development of a strong immune system, and promotes bonding and emotional well-being. 

The IMPLICIT Network supports breastfeeding practices by connecting birthing people to lactation services through our 4th trimester model, and providing a space for birthing people to discuss lactation with their provider.

#IMPLICITNetwork #NationalBreastfeedingMonth #4thtrimester #breastfeeding
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