Fetal Infant Mortality Review (FIMR) Project
Fetal and Infant Mortality Review (FIMR)
FIMR identifies strengths and areas for improvement in overall service systems and community resources for women, infants and families. It also provides direction towards the changes in service systems and the development of new policies to safeguard them.
FIMR began in 1990 as a collaborative effort between the American College of Obstetricians and Gynecologists (ACOG) and the Federal Maternal and Child Health Bureau (MCHB). Since it was first introduced in the late 1980’s, FIMR has been a dynamic, community process and has enjoyed continued growth and refinement as more communities have used it. Today, there are over 200 FIMR programs. While the basic methodology is the same in most programs, the specific recipe for actual operation is local. Funding sources vary from community to community. Different types of agencies sponsor the FIMR program including city and county health departments, local hospitals, regional perinatal centers and community-based maternal and child health coalitions.
Florida adopted the FIMR model in 1992. The Healthy Start Coalition of Miami-Dade has been contracted by the State of Florida to implement FIMR locally. FIMR of Dade County is one of 11 FIMR projects statewide organized under Florida Statute 766.101 and funded by the State of Florida.
What is FIMR?
- a strategy to close the gap in health disparities at the community level
- a timely and valuable source of information for evaluating changing health care systems and how they affect real families trying to access them
- a community coalition that promotes volunteerism and good citizenship and will translate into local accountability
- a community coalition that can represent all ethnic and cultural views in the community
- a strategy that improves communication among health and human service providers
- a form of continuous quality improvement (CQI) that allows communities to assess the performance of systems and the impact of changes in those systems
- a voice for local families who have lost their baby
- a tool that helps local health officials implement policies to safeguard families
- a program endorsed by the ACOG, the March of Dimes Birth Defects Foundation and the federal MCHB
Benefits of FIMR
- a warning system that can describe effects of health care systems change
- a method for implementing continuous quality improvement (CQI)
- a means to implement needs assessment, quality assurance and policy development as well as essential public health functions
- For the family experiencing a fetal or infant loss, the FIMR interview process itself may help move them through the stages of grief and improve their ability to cope with the loss.
- For institutions and providers, FIMR findings lead to improved quality of services. This also means both duplications and gaps in services can be avoided.
- For communities, the FIMR process empowers the community to create solutions where none existed and can improve existing service systems and community resources for women, infants, children, and families.
- All information collected from medical records and the maternal interview is stored in locked files.
- All identifying information (the patients’ names, the providers’ names, hospital/clinic sites) is removed prior to review by the Case Review Team (CRT).
- All CRT members and HSCMD (project) staff are required to sign a pledge of confidentiality which prohibits them from discussing reviews outside team meetings.
*THE REVIEWS THEMSELVES ARE CLOSED TO THE PUBLIC.
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