12/07/2021: Important Update for Midwives

Dear Midwives,

Peer Review is going 100% self-service, immediate, and paperless. We are acutely aware of how difficult this process has been for you and deeply apologize for the stress and distress this has caused.  We are committed to serving you, our members, and recognize that you are busy catching babies and serving families, and have commitments to your clients as well as to your malpractice insurance and certifying bodies, and need certificates in a timely way.  

We tried a fix this past year and unfortunately it didn't work as well as hoped.  

With this season change, we recognize that while it has always been the responsibility of each individual midwife to make peer review meaningful and educational, it is also each midwife's responsibility to guarantee confidentiality, a quorum of 4 professional midwives, and compliance with DOH guidelines that allow for legally protected peer review.  

With the new process, after conducting a peer review, each participant will fill out an online form answering the necessary questions and attest to confidentiality and active professional MAWS membership.  Upon completion, your certificate will be emailed to you within minutes.  

Troubleshooting:  If you don't receive your certificate within a few minutes of completing the form, try the following:

• Refresh your inbox and check your spam folder
• Ensure that you entered the correct email address with no typos
• Ensure that you answered all questions completely, including entering an "N/A" to any that don't apply.
• If all else fails, email MAWS at QMP@washingtonmidwives.org

You can complete the form as many times as you need to.

MAWS and the QMP will be auditing responses on a monthly basis to ensure all is running smoothly, but will not need to process each individual certificate.

We hope these new changes work well for you. We are open to feedback to ensure the process works seamlessly.

Sincerely,
Melanie Dickson, LM CPM, QMP Co-chair and the MAWS  Board and QMP Committee

A MAWS Member’s Guide to the MAWS Quality Management Program: Incident & Peer Reviews

​Regular engagement in reflective self and peer evaluation is a public demonstration of the midwifery profession's commitment to providing safe, responsible, family-centered maternity care. The Quality Management Program (QMP) is state sanctioned and legally protected by WAC 246-834-360.  It was established by MAWS in 2003 with the aim of furthering the autonomy of the midwifery profession and improving practice and outcomes, and is administered by the QMP committee. The protected space of Peer Review and Incident Review enables midwives to freely discuss clinical cases with their peers, safe from subpoena or legal inquiry.
 
The two branches of the QMP program provide mechanisms for quality improvement:

• a) Peer Review which each midwife must complete  every two years with at least three other professional MAWS members (professional MAWS members must be WA State Licensed Midwives), and
• b) Incident Review which is organized by the QMP committee and is conducted by a specially convened panel whenever an outcome occurs which meets “Sentinel Event” criteria (see below).
  • Click here for the Incident Self-Report Form

 
The Quality Management Program (QMP) exists to:

• Help midwives improve their practice
• Help improve future outcomes
• Create a safe forum for discussion of clinical cases
• Generate ideas directly from the membership for continuing education​

As of 2021, MAWS is pleased to announce three changes to Peer Review and Incident Review which will streamline both processes.

1. Getting Peer Review certificates is now entirely self-service, paperless, and immediate. We recognize that while it has always been the responsibility of each individual midwife to make peer review meaningful and educational, it is also each midwife's responsibility to guarantee confidentiality, a quorum of 4 professional midwives, and compliance with DOH guidelines that allow for legally protected peer review.  
   
   With the new process, after conducting a peer review, each participant will fill out an online form answering the necessary questions and attest to confidentiality and active professional MAWS membership.  Upon completion, your certificate will be emailed to you within minutes.  
   
   Here's the link: https://docs.google.com/forms/d/1q8Ze5CIZdL96ItJoq9TkHBem4sdxpW1zZ5nHGirRldE/edit
   
   Troubleshooting:  If you don't receive your certificate within a few minutes of completing the form, try the following:
   1. Refresh your inbox and check your spam folder
   2. Ensure that you entered the correct email address with no typos
   3. Ensure that you answered all questions completely, including entering an "N/A" to any that don't apply.
   4. If all else fails, email MAWS at info@washingtonmidwives.org
   5. You can complete the form as many times as you need to.
2. All Incident Review docs should continue to be faxed through the secure fax number: 1-206-691-8203. Documents received through USPS to the following address:  MAWS attn QMP, 16904 Juanita Drive NE #203 Kenmore, WA 98028 will still be received, but there may be delays in processing.
3. Students midwives are now allowed to participate in Peer Review if they are:
   1. A MAWS member
   2. Accompanied by their precepting midwife
   3. Approved by all midwives who will be part of the Peer Review

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Responsibilities of MAWS Professional Members
 
As MAWS members, we all have a shared responsibility to:

• Agree to participate as a panelist on an Incident Review Panel when called upon to do so
• Maintain strict confidentiality whenever participating in Peer Review or on an Incident Review Panel
• Turn in a Self-Report to the QMP within 14 days if any of the following “Sentinel Events” occur. If you are uncertain about whether a serious event meets criteria for an Incident Review, please submit one. You can view a sample Self-Report form here. 
  ​Sentinel Events:
  • Maternal Mortality
  • Perinatal Mortality
    
  • Maternal shock or ICU admit
  • Uterine rupture
  • Maternal/neonatal seizure
    
  • Uterine inversion
  • NICU or Special care nursery admissions within 72 hours of birth (except for observation &/or congenital anomalies)

​                                                                             Click here for Incident Review Instructions.
​

• Participate in a MAWS Peer Review: MAWS members are required to complete Peer Review of 5 charts every 2 years, in alignment with Washington State’s new Peer Review requirement for licensure. For Peer Review to meet the requirements and remain protected, there must be at least four licensed midwives, all of whom are CURRENT MAWS members. You can check your member status via your profile at https://maws.wildapricot.org/.

​Please contact us if you have questions:
Incident/Peer Review and general QMP correspondence: QMP@washingtonmidwives.org
OR FAX to the QMP at: 1-206-691-8203
​

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How to File a Complaint

MAWS is aware that some healthcare providers, consumers, or family members may have concerns about the care provided by a Licensed Midwife who is also a MAWS member. Any patient, client, family member, healthcare provider, allied birth professional, or facility may file a complaint against one of our midwives to the Quality Management Program (QMP). Click here to download the Complaint Form. Please be aware that a review of the event in question requires contacting the midwife and reviewing the chart notes, and therefore we cannot maintain client anonymity.  The QMP upholds the highest standards of confidentiality and safety.  Because of this very commitment to confidentiality, complainants will not receive any information about the results of such a review. ​

Once a complaint is received, the QMP Committee reviews the information and begins a review if the case meets criteria for investigation. Review panels are convened and the findings are reported back to the MAWS QMP committee. If any laws have been broken we are obligated to notify the Department of Health.
​
As a statewide midwifery organization, we appreciate your feedback in order to identify practice trends or any gaps in education. We organize annual Continuing Education Conferences for our members based partly on incident and peer review data. MAWS members are committed to the continuous improvement of maternity care services in Washington State.