Fatality Review Team News December 2020

Sat Dec 19 07:09:26 PST 2020

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  Fatality Review Team News                                             December 2020

New NCFRP News

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Visit our website<https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=753b3792b3&e=5d2cd2fe8d>
Greetings from the Staff
[A picture containing outdoor, sky, person, water  Description automatically generated]Margaret Hefferenan, best-selling author of the book Uncharted: How to Map the Future Together, said,"The one thing we know about the future is that we do not know the future." We have now been living in these uncertain and unprecedented times of the pandemic for over nine months, enough time to have conceived and given birth to a human newborn! We have heard from so many of you, hear of the creative and innovative ways that you have kept your fatality review meetings going, virtually and in-person (with herculean safety measures!). We have also heard from colleagues who are deployed exclusively to COVID activities, working countless hours to keep their communities safe and healthy.  We acknowledge that months of remote video conferences and physical distancing is starting to wear many of us down.  As we approach what for many may be a very difficult holiday season, I would like to offer a suggestion.

Take time to notice the good. Every day try to make a commitment to notice the good things around you... it doesn't have to be something huge, something as simple as, "that was a great lunch," or "that house has some beautiful holiday lights" can help orient you to the positive.

We may not know the future, but we do know the importance of hope. We are attracted to hope; we have hope because we see evidence of a better future.  When we have hope, we understand that the unique human qualities of kindness, patience, and compassion are even more contagious than the virus itself.

We support you and thank you for all that you do!
Rosemary Fournier,
FIMR Director
Upcoming Events

Regional FIMR Support Calls

  *   Western Region (CA, MT, NV, UT, WY): January 13, 2021, 4:00-5:00 PM EST
  *   Northern Region (WV, PA, NJ, DE, MD, ME, DC): January 19, 2021, 9:30-10:30 AM EST
  *   Midwest Region (MI, WI, OH, IL, IN): January 19, 2021, 11:00 AM -12:00 PM EST
  *   Central Region (CO, NE, KS, OK, TX, MO, LA): January 25, 2021, 11:00 am-12:00 PM EST
  *   Southern Region (KY, TN, MS, AL, FL): January 28, 2021, 10:00-11:00 AM EST
State FIMR Coordinators Conference Call
March 3, 2021, 3:00-4:00 PM EST

Fatality Review Health Equity Learning Collaborative
March 10, 2021, 3:00-4:30 PM EST

Field Notes
Broward County FIMR Supports Robust Safe Sleep Efforts
[A person holding a baby  Description automatically generated]The Broward County FIMR program reviews about 17 unsafe infant sleep death annually.  These high numbers of preventable deaths spurred a county-wide infant safe sleep program which includes the following components:

  *   Creation and distribution of safe sleep promotional materials: Tote Bags & Onesies promoting the ABCs of Safe Sleep
  *   County wide ordinance was passed in 2018 requiring all licensed daycares to follow the American Academy of Pediatrics (AAP) 19 safe sleep recommendations
  *   Radio interviews reaching diverse audiences within Broward County
  *   Digital safe sleep banners on local radio station websites
  *   Enhanced review of the circumstances surrounding sleep-related deaths to better drive prevention
  *   Dissemination of 450 portable cribs to families of infants
  *   Creation and dissemination of flip books highlighting the safe sleep message to be used in the home visiting context
  *   YouTube video highlighting the basics of safe sleep along with a tutorial on how to set up and take down a portable crib
  *   Monthly safe sleep trainings to various community partners
  *   Ongoing monthly meetings of the Safe Sleep Committee & Healthcare Subcommittee to address concerns and continue the promotion of the AAP's 19 safe sleep recommendations
  *   Creation and dissemination of a SIDS Awareness Month Toolkit for providers and community partners to use to digitally share/promote the safe sleep message
  *   Model behavior nurses contracted through the program to provide trainings to nurses and other hospital personnel on following the AAP's recommendations and therefore "modeling" the safe sleep behaviors in front of the parents and providing the proper education on safe sleep before the families are discharged from the hospital
 Findings from the Broward County FIMR continue to drive and refine this multi-pronged campaign. For more information, visit:
https://www.fortlauderdale.gov/departments/fire-rescue/community-programs/safe-sleep-program<https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=b77812e5d3&e=5d2cd2fe8d>

States Facilitate, Engage, and Train CDR Partners amid COVID-19

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Both South Dakota and New York State hosted trainings for local or regional review teams in October.

South Dakota has two regional child fatality review teams, one east and one west of the Missouri River. Abby Collier, the director of the National Center, and her colleague Susanna Joy participated in the West River Region's Death Review Training. They presented on 10 Steps to Effective Reviews as a part of the day of training and heard innovative and effective strategies from the regional team coordinator in Rapid City. The participants met in a large room, wore masks, and socially distanced. National Center staff presented remotely on a large screen.

Jill Munger, South Dakota's child fatality review coordinator,  is an example of what  the pandemic has asked of many fatality review professionals. In addition to moving a significant amount of her FTE to the COVID response in her state, she also assisted with seasonal flu clinics for South Dakota state employees. (You can see her in the lower left corner of the above photo, getting vaccine materials out of a cooler.)

Three weeks later, Susanna presented similar content to the New York State local team coordinators. facilitating discussion and shared problem solving with the coordinators. This training was fully remote, hosted on a Zoom platform, and had about 50 participants. Using breakout rooms and remote facilitation tools made the training more interactive and kept participants engaged. Robust coordinator discussions focused on information sharing and records access to facilitate effective reviews.

State fatality review partners continue to illustrate that, even in the middle of the pandemic, there are creative ways to address barriers for state and local team efforts. The National Center staff is ready and willing to help state programs consider how to facilitate ongoing efforts in a time of increased expectations and uncertainty. Please reach out with questions, concerns, or simply to brainstorm with the National Center's technical assistance staff at info at ncfrp.org<mailto:info at ncfrp.org?subject=TA%20Inquiry>.

FIMR Leverages the Power of Stories for Social Change
The National Center for Fatality Review and Prevention is partnering with MP3 Health Group, (Dr. Magda Peck, ScD, founder/principal) to explore how to integrate the science and best practices of storytelling with existing community-based FIMR processes. In March 2020, a design team was assembled to inform the design and implementation of a pilot program to orient and train selected FIMR Teams on harnessing the power of stories for social change,   with focus on improving perinatal outcomes. Initially, a day-long hybrid capacity-building workshop and design session, on Storytelling for Social Change - Opportunities for FIMR  was planned for early June, but COVID-19 derailed that plan and the effort quickly shifted to a four-session virtual collaborative opportunity with 5 FIMR sites selected to participate. The virtual session began in September and ended on December 10th with a storytelling showcase.

The planned outcomes for this collaborative were:

  1.  The Design Team and participating FIMR teams will increase their knowledge and understanding about how to use powerful stories and strategic storytelling in FIMR practices and processes, for greater impact.
  2.  Participating FIMR teams will enhance their individual and collective capacity to invite and incorporate strategic storytelling into their work, to exert greater influence on services and systems change.
  3.  The Design Team will make preliminary recommendations to the National Center for incorporating storytelling practices into the FIMR process, with paramount attention to the voices of Black, Indigenous and People of Color (BIPOC) women and cultural humility.
Representatives from 5 FIMR teams participated in the sessions from Broward County, FL; Kansas City, MO; Baltimore City, MD; Kalamazoo County, MI: and Washoe County, NV. Dynamic guest faculty have included Dr. Wanda Barfield, CDC's Director of the Division of Reproductive Health; Kenn Harris, Senior Project Director, National Institute for Children's Health Quality (NICHQ); Dasha Kelly-Hamilton,  Still Waters Collective and Poet Laureate for the City of Milwaukee, WI; and Janelle Palacios, CNM, Kaiser Permanente.

Do you know of an innovative fatality review practice, successful project, partnership, or other activity from a state or local program that the National Center could share in "Field Notes?" We welcome your suggestions at info at ncfrp.org<mailto:info at ncfrp.org?subject=Suggestion%20for%20%22Field%20Notes%22%20in%20the%20newsletter>.
Kudos Corner
Fireplay Publication Uses CDR Data
[cid:image010.jpg at 01D6D5D5.DD54C980]The National Center is pleased to recognize the publication of Social and Demographic Characteristics and the Contribution of Fireplay to Fire-Related Mortality Among Children in the U.S., 2004-2016, in the  American Journal of Preventative Medicine's December 2020 issue. The article was authored by Dr. Patricia Schnitzer and Heather Dykstra. Dr. Schnitzer provides epidemiologic support to the National Center, and Ms. Dykstra works as a senior data analyst.

The paper examines 1,479 deaths of children due to fires that were reviewed in child death reviews and entered into the National Fatality Review-Case Reporting System. Of these, 175 of the deaths were due to fireplay. When children play with fire or fire-starting materials such as matches, lighters, or candles, it is considered fireplay. The analysis found that, compared to non-fireplay-related deaths, children who died in fireplay fires were more likely to be aged 1-4 years old, male, have supervision documented as "no, but needed" in the NFR-CRS, and were more likely to have an open case with a child welfare agency. Congratulations to the authors! The article is available here: https://www.ajpmonline.org/article/S0749-3797(20)30294-4/fulltext<https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=f932404a7c&e=5d2cd2fe8d>.

HealthDay Highlights Fatality Review Findings
[A picture containing text, electronics, person, keyboard  Description automatically generated]Twenty-two CDR states and jurisdictions are currently funded by the Centers for Disease Control and Prevention (CDC) to participate in the Sudden Unexpected Infant Death (SUID) Case Registry. Through a collaboration with the National Institutes of Health (NIH), 13 of these awardees are also funded to participate in the Sudden Death in the Young (SDY) expanded component. Through these cooperative agreements, states/jurisdictions use the NFR-CRS and existing CDR programs as a foundation for reporting 100% of their SUID and/or SDY deaths into the registry, providing population-level surveillance for those participating. This focus on sudden, unexpected deaths includes sudden unexpected death in epilepsy, or SUDEP.

HealthDay, a leading online producer and syndicator of evidence-based health news, recently published an article about SUDEP, Sudden Death More Common Than Thought in Very Young With Epilepsy, (URL: https://consumer.healthday.com/b-12-4-sudden-death-more-common-than-thought-in-very-young-with-epilepsy-2649099510.html<https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=76bdeffff4&e=5d2cd2fe8d>), describing findings from the SUID and SDY Case Registry. The analysis the article describes examined 1,769 sudden, unexpected deaths reviewed by Registry grantees for which data were entered into the NFR-CRS between 2015-2017. Of these, deaths, 3% were determined to be SUDEP and 1% as possible cardiac death/SUDEP.

Congratulations and sincere thanks to partners at CDC, NIH, and in the funded jurisdictions for continuing the work of understanding sudden, unexpected deaths, one case review at a time.
For more information on SUDEP, visit: https://www.cdc.gov/epilepsy/about/sudep/index.htm<https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=e903121236&e=5d2cd2fe8d>
To learn more about the SUID and SDY Case Registry, visit: https://www.cdc.gov/sids/case-registry.htm<https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=552f9921fc&e=5d2cd2fe8d>
Michigan FIMR Program Honored by AMCHP
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The Association of Maternal and Child Health Programs (AMCHP) has awarded the Michigan Fetal and Infant Mortality Review (FIMR)<https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=cbdcc46948&e=5d2cd2fe8d> program with an Innovation Station Cutting-Edge Practice award for its efforts to improve its review process. As part of the award, the program's work will be showcased in the AMCHP Innovation Station to encourage other states and territories to replicate and explore Michigan's process. Click here to check out Michigan FIMR's work at the Innovation Station: https://bit.ly/3qs1DrO<https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=7e2e42b903&e=5d2cd2fe8d>
Data Matters
National Center Releases Infographic
[Graphical user interface, application  Description automatically generated]In conjunction with the publication of Social and Demographic Characteristics and the Contribution of Fireplay to Fire-Related Mortality Among Children in the U.S., 2004-2016 in the American Journal of Preventative Medicine, the National Center is releasing a Quick-Look infographic, Accidental Deaths of Children due to Fireplay. The Quick-Look highlights data from the study, including race and age demographics, incident details, and fire characteristics. It also compares fireplay deaths to the fire deaths unrelated to fireplay. Finally, it provides resources to support prevention efforts. This Quick-Look, and all of the National Center's infographics, are available here: https://www.ncfrp.org/center-resources/quick-looks/ <https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=dcc4fc8420&e=5d2cd2fe8d> .
National Center Adds Icons to Identify Priority Variables in NFR-CRS
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To support CDR teams in improving data quality, the National Fatality Review-Case Reporting System (NFR-CRS) will be updated to show star icons next to priority variables, as seen above. A gold star will appear next to priority variables for the National Center's Data Quality Initiative. For jurisdictions funded as part of the Sudden Unexpected Infant Death and Sudden Death in the Young Case Registries, a purple star will appear next to Registry priority variables. Both stars will appear if the variable is a priority variable in both contexts.  When a user hovers over an icon with their cursor, text explaining the icon will apear, as seen below. The priority variable icons will be added into the NFR-CRS in the first week of January 2021. The National Center hopes adding this visual aid to the online data entry system will help users readily identify essential variables that will guide future prevention efforts.

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Resources for Prevention
National Center Releases Guidance on Reviewing Suicide Deaths

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In addition to being an increasing problem in many parts of the country, suicide remains a devastating outcome faced by many CDR teams. Teams often find it hard to get certain data, or that initial investigations are sometimes lacking.

In response, the National Center has released Suicide Best Practices: National Center Guidance Report. The guidance provides context, health equity considerations, and key questions to ask in both the initial investigation and in suicide case reviews. It includes information on documenting suicide deaths in the NFR-CRS, self-care considerations for teams, and opportunities for and examples of successful prevention efforts. It also highlights resources to support suicide prevention.

To access the guidance, visit: https://www.ncfrp.org/wp-content/uploads/Suicide_Guidance.pdf<https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=2f349808f2&e=5d2cd2fe8d>.
Safe Sleep Stickies Can Educate Non-Parental Caregivers
[Text, letter  Description automatically generated]Karel Amaranth's 15 years of experience in child fatality review, and some recent case reviews, made her spend some time considering what parents can do to equip non-parental caregivers to practice infant safe sleep. "I had the thought that parents needed a tool to educate, remind, inform caregivers, and as I glanced around my own desk... I realized how I remind myself and provide information to others: sticky notes," Amaranth shared in Can We Stick to the Message of Safe Sleep and Prevent Infant Deaths?- a submission to the Maternal Child Health section of the American Public Health Association. "Sticky notes with safe sleep information could be stuck on a refrigerator, on a wall near where baby would be sleeping, or on a diaper bag."

The Safe Sleep Sticky Notes include the ABCs of Safe Sleep, as well an area to personalize them with the baby's name and include parental contact information.

"The Safe Sleep Stickies cannot protect against all dangers. Certainly, from my participation in infant death reviews... I know that saving lives can be complex and requires large scale interventions, medical science and technology, but I also know that saving lives can be accomplished by simple behavioral changes: wearing a seat belt, wearing a mask... washing our hands for 20 seconds," Amaranth said.

If you would like a sample of the Safe Sleep Sticky you may request one from Ms. Amaranth at karel.amaranth at gmail.com<mailto:karel.amaranth at gmail.com>.
New and Departing Coordinators
Welcome!

  *   Ashley McKinley, CDR and FIMR Coordinator, Ohio
  *   Angela Winogradov, Humboldt County, CA FIMR
  *   Deanna Bridge-Najera & Denise Heffernan, Carroll County, MD FIMR
  *   Angela Cochran, St. Mary's County, MD FIMR
  *   Ashley Milcetic, St. Mary's County, MD
  *   Tianna Leon, Ingham County, MI FIMR
  *   Akivia Cannon, Florida State FIMR Coordinator
  *   Kasia Wilczek, Gennessee County MI FIMR
  *   Jeela Taylor, Knox County, TN FIMR
  *   Kiwan Lawson, Indiana State FIMR Coordinator
Farewell

  *   Emily Adams, Humboldt County, CA FIMR
  *   Cindy Marucci-Bosley, Carroll County, MD FIMR
  *   Dawn Porter, Arkansas State Child Fatality Review Coordinator
  *   Nicki Sullivan, Montana FICMMR
Center Staff (not so) Out & About
While National Center staff has not been traveling to provide technical assistance during the pandemic, they have provided virtual trainings to diverse partners across the country. Some highlights of the National Center's virtual technical support include:

  *   Multiple National Center staff participated and exhibited at the virtual CityMatCH Conference, September 16-18th. Rosemary presented a workshop called FIMR/HIV: A Systems-Level Tool for Ending the HIV Epidemic among Pregnant and Postpartum Women and Their Infants.
  *   Abby and Susanna presented 10 Steps to Effective Fatality Reviews to the South Dakota West River Training in early October. Later that month, Susanna facilitated a training for the local CDR team coordinators in New York State.
  *   The National Center presented two webinars in the last quarter of 2020: Incorporating Trauma-Informed Systems and Practices into Fatality Review, and Reviewing Suicides: Best Practices, Success Stories and Resources. All of the National Center's webinars are archived and available for viewing at https://www.ncfrp.org/center-resources/archived-webinars/#fe26090611083fd72<https://ncfrp.us5.list-manage.com/track/click?u=4cdf76c24103d4aa09dbe9cc7&id=9ee9e22efa&e=5d2cd2fe8d>.

If you have a training need, the National Center will be happy to connect with you to find a creative solution and provide technical assistance or training to your program. Reach out to us info at ncfrp.org<mailto:info at ncfrp.org?subject=Technical%20assistance%20request>!

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