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Years Active: 2016-2017




The aim of this project is to standardize approaches to recognizing and responding to maternal hemorrhage in the postpartum period to reduce severe maternal morbidity and mortality in Tennessee birthing hospitals. The immediate aims of this project for 2017 are to increase by 25% above 2016 results the number of Tennessee births for which blood loss is cumulatively quantified, and to report monthly the number of women in Tennessee birthing hospitals who receive 1) a blood transfusion 2) more than four units of packed red blood cells after birth and 3) hemorrhage risk assessment on admission.

The membership of TIPQC voted to develop a Postpartum Hemorrhage Project in 2013. The project has been active since 2016.

Eight teams from across the state, facilitated by Cathy Ivory, PhD, RNC-OB and Connie Graves, MD, have been focusing on cumulative quantification of blood loss (QBL) at birth. After six months of data collection, teams cluster slightly above or below 50% QBL for vaginal births. Teams also measure blood products received by women during admission for childbirth. Our results are variable and are similar to results reported by other state perinatal collaboratives; we anticipate steady improvement moving forward.


Hospital Teams

  • Baptist Memorial Hospital for Women
  • Erlanger Medical Center
  • Erlanger East Hospital
  • Ft. Sanders Regional Medical Center
  • Johnson City Medical Center
  • Maury Regional Medical Center (Withdrew in June 2017)
  • Regional One Health
  • Vanderbilt University Medical Center
  • University of Tennessee Medical Center, Knoxville

State Project Leaders

Connie Graves, MD and Cathy Ivory, PhD,  RN-BC, RNC,OB, FAAN led this project. 

Dr. Graves has been involved with TIPQC since its inception and is a Maternal Fetal Medicine specialist.  Dr. Graves is the Medical Director, Tennessee Maternal Fetal Medicine, Director of Perinatal Services, St. Thomas Health, Co-Director of the Comprehensive Perinatal Cardiac Clinic, St. Thomas Health, Professor – University of Tennessee, Clinical Professor – Vanderbilt University, and Adjunct Professor – Meharry Medical College.  She also serves on many state and national boards and is widely published. 

 Dr. Ivory is an Associate Professor, Senior Director of Nursing Research, Vanderbilt University Medical Center and served as the TIPQC Maternal QI Specialist. 



TIPQC is actively recruiting devoted health care professionals, community leaders and patient and family partners to further our mission of improving health outcomes for mothers and babies in Tennessee.