FIMR Principles

Status of FIMR in the US Reports
Operating Principles

Status of FIMR in the US Reports:
Status of FIMR in the US: 2015
Status of FIMR in the US: 2016

The Operating Principles of Fetal Infant Mortality Review 

  • Infant mortality is the most sensitive index we possess of social welfare (Julia Lathrop, Children’s Bureau, 1912 – 1920)
  • The death of an infant is a community problem, and is too multidimensional for responsibility to rest in any one place
  • Fetal and infant deaths are sentinel events that illustrate system and resource issues.
  • FIMR’s two tiered process enhances program effectiveness
  • The Maternal interview includes the voices of others who have lost an infant and offers information not available through routine quantitative methods
  • Reviews lead to identification of factors contributing to fetal and infant mortality
  • Review should focus on prevention and should lead to effective recommendations that improve the systems of care and resources for women, infants, and families

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The Purpose of Fetal Infant Mortality Review

To conduct comprehensive multidisciplinary review of fetal and infant deaths to understand how a wide array of local social, economic, public health, educational, environmental and safety issues relate to the tragedy of infant loss; and use the findings to take action that can prevent other infant deaths and improve the systems of care and resources for women, infants, and families.

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The Objectives of Fetal Infant Mortality Review

  1. To Examine and identify the significant health, social, economic, cultural, safety and education systems’ factors that are associated with fetal and infant mortality through review of individual cases
  2. Plan a series of interventions and policies that address these factors to improve the service systems and community resources
  3. Participate in the implementation of community-based interventions and policies
  4. Assess the progress of the community-based interventions
  5. Identify barriers to care and trends in service delivery and suggests ideas to improve policies and services that af­fect families.

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  • Communities need better information about the operation of family services and their impact in order to plan for the future
  • Communities needs information about the effects of changes in the health care system on mothers and infants
  • Existing needs assessment does not seem to adequately reflect the concerns and prob­lems of the community
  • Local entities need a way to strengthen the core public health func­tions or to institute a continuous quality improvement system
  • Local coalitions want to begin working together on better policies for families in their community
  • Indicators of maternal and infant health status are changing for the worse (e.g., rates of fetal, infant or post neonatal mortality, or rates of preterm births are increasing)
  • Disparities in infant mortality across com­munities or racial/ethnic groups are too great

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  • an action-oriented process leading to creative ideas to improve
  • community resources and service systems for women,infants and families
  • a timely and valuable source of information about 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 and pride
  • a community coalition that can represent all ethnic and cultural views in the community and becomes a model of respect and understanding
  • an effective strategy to address maternal and infant health disparities with specific community action, which is culturally appropriate and championed by respected community messengers
  • a cost-saving process maximizing efficient use of local services and resources
  • a strategy that improves communication among health and human service providers
  • a method that takes the most successful process, continuous quality improvement, to produce better products and applies it to produce better health care for children and families
  • a voice for local families who have lost their baby
  • a tool that helps local health officials achieve the core public health functions of assessment, assurance and policy development to safeguard families
  • a methodology thoroughly evaluated by Johns Hopkins Bloomberg School of Public Health and found to be an effective perinatal systems intervention

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