More than 80% of women who are pregnant are not at the level (40 ng/ml) that has been shown to be most helpful in preventing preterm births.
The project, Protect our Children Now! initiated by GrassrootsHealth (GRH), is being implemented at the Medical University of South Carolina (MUSC) in a 2 year project starting early 2015. Its major aim is to provide education, vitamin D testing and ongoing supplementation to pregnant women to help them achieve a vitamin D status of 40 ng/ml, and of course, to track the outcomes. In order to do this, a quality improvement program was initiated at MUSC, and GRH is providing all of the implementation services to help this happen.
The key components of this program are education and vitamin D testing. In fact, all of the obstetricians (OB), the staff and the pregnant women are taught about the role of vitamin D in the body. We have provided online continuing education videos for CME credits for the medical personnel; there are all kinds of information pieces for everyone, including weekly emails to the staff, posters in the elevators and handout materials for the patients with the education nurse. There is also an onsite person who works with the women as they come in for their appointments, attends staff meetings to discuss vitamin D and answer questions. Attention and education at the point of encounter are considered key parts of the success.
As a result of initial activities, MUSC made the testing of ALL the pregnant women part of their incoming prenatal test panels with follow up if anyone was less than 40 ng/ml. This was adopted by the OB Board at MUSC so this is a standard protocol for prenatal care. This will mean that we (GRH) will have records and information on approximately 2000 women during their pregnancies over a year’s time. This is a phenomenal amount of data and will allow us not only to track health outcomes but track many operational measures to help ongoing evaluation of the implementation process.
The staff has been quite supportive of the process. There is a very immediate recognition of the vitamin D deficiency problem. Needless to say, Dr. Roger Newman, the physician in charge, is actively involved in helping with the ongoing education and awareness. His presence and credibility alone are noteworthy.
The initial funding was provided by one of the managed care insurers, in part due to their knowledge of the early RCT done by Dr. Wagner and Dr. Hollis on vitamin D and pregnancy. We are expecting more insurers to start taking part due to the very significant savings from the preterm birth prevention. It is estimated that MUSC will be saving approximately $8MM per year with this process, according to the March of Dimes estimated cost of $55,000/preterm birth.
We are now starting projects in Montana, another in South Carolina and 2 others in different parts of the US. It is a project that can easily be implemented in an organization that’s ‘ready’ to make a change!
Baggerly, Carole. A closer look at the GrassrootsHealth project, Protect our Children NOW! The Vitamin D Council Blog & Newsletter, December, 2015.