ABSTRACT/SUMMARY Clinical evidence of persistent preventable maternal deaths along with patient surveys and personal stories in the United States due to suboptimal interpersonal care leave no doubt that variability in treatment and care approaches during the perinatal period contribute significantly to maternal death. Central to identifying the factors to reduce maternal mortality are interventions for healthcare providers and institutions to recognize and reduce these contributing clinical and procedural factors of preventable maternal deaths. Our long-term goal is to make patient-centered maternity care practices the standard across the care continuum—pre-conception to 1-year postpartum—to reduce preventable maternal morbidity and mortality outcomes. The overall objective for this application, which is the next step toward attainment in our long-term goal, is to demonstrate a multifaceted, evidence-based intervention will reduce preventable maternal morbidity and mortality outcomes. Our central hypothesis is that hospitals that implement the multifaceted intervention of training, incorporating evidence-based communication and care practices in all quality improvement efforts, and coordinating with local organizations to optimize outcomes will have better outcomes than hospitals who have implemented remote asynchronous training alone. The rationale that underlies the proposed research is that a determination of the link between patient-centered maternity care and preventable maternal morbidity and mortality is likely to offer strong scientific rationale for taking a multifaceted approach to improving maternal morbidity and mortality outcomes. Our research strategy will be to conduct a multi-hospital cluster randomized controlled trial (RCT) within 9 Ochsner hospitals (~1900 staff and 14000 deliveries per year) to compare an interactive multifaceted intervention— patient-centered maternity care practices training, technical assistance to support evidence-based communication and care practices in quality improvement, and partnership building— to a remote asynchronous training alone intervention. Maternal health will be measured by a composite outcome matched to ACOG patient safety bundle recommendations, collected centrally through electronic health records, and patient satisfaction by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) routinely collected data. This will enable us to achieve the following Aims: 1) Determine the effect of a multifaceted patient-centered maternity care intervention on hospital maternal outcomes and patient satisfaction; 2) Determine the effect of a multifaceted evidence-based maternity care communication and care practices intervention on provider decision making; 3) Examine how a hospital-level patient-centered maternity care and implementation of evidence-based communication and care practices impacts patient and hospital staff satisfaction. These results are expected to have an important p...