Focused Action Cycle


Over 5–6 months, our Action Collaborative brings interdisciplinary teams together to strengthen emergency preparedness, build systems and relationships, and create lasting improvements in perinatal care.

Participants say:

Quote

“I can’t imagine [opening a new birth center] without your guidance. it absolutely superseded my expectations.” – Birth Center CNM

Action Collaboratives include:

Seven Monthly Training Sessions: Interactive virtual sessions combine group coaching, best practices, and live Q&A. Each session dives into specific tools and strategies to strengthen collaboration and emergency response.

Ready-to-use Drill Kits: Participants receive tools to conduct full or partial emergency transfer drills on clinical scenarios including intrapartum, postpartum, and neonatal emergencies, tailored to their needs.

Group Coaching & Debriefing: A team of expert faculty guides didactic learning, while a final Community Debrief session allows teams to share insights and challenges, maximizing collective learning.

Customizable Support: Whether you’re building new clinical relationships, scaling your community birth practice, or preparing for state or national impact, an Action Collaborative offers tailored guidance to meet your QI goals.



Action Collaboratives have a powerful impact.



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Drill Kit 2024 map results
🌟 Download the 2024 Action Collaborative results report


Quotes from recent Step Up Together participants:

Quote 1

“This is stuff we can actually use. You have the whole program written and done for us. We don’t have time to figure that all out. But it’s so important.” – Birth Center CNM

Quote 2

“All hospitals oughta be… seeking out their birth centers and participating in a program like this and doing drills because it benefits everybody.” – NICU Medical Director




We are actively seeking partners ready to convene a 2025 Action Collaborative for measurable results and lasting improvements in care for birthing families.






Who Should Convene an Action Collaborative?



Funders building relationships with community birth providers.

Hospitals and health systems Funders with a vision or a mandate to improve maternity and perinatal care quality and equity on a broader scale.

State and regional organizations seeking to scale quality improvement initiatives.

State and regional organizations seeking to scale quality improvement initiatives.



Contact us today to learn more about partnering with Step Up Together and starting your own collaborative.



Frequently Asked Questions

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Step Up Together Drill Kits support interdisciplinary clinical teams to run emergency drills involving transfer of care.

Each Drill Kit can be used to run a Full Transfer Drill that begins in the community, travels by ambulance, and ends in the hospital or to run just one segment of the drill (e.g. before transfer or after hospital hand-off). The toolkit includes a standardized high-fidelity case designed to test the process of transferring a birthing person or newborn from one location to another with an interdisciplinary team involved in the care. Observation criteria and a Debriefing and Action Guide are provided to elicit continuous improvement of transfer processes and respectful care along the continuum.

Step Up Together Community Debriefs bring implementing teams from different sites together to maximize cross-learning and minimize reinventing the wheel. Each team goes through a structured process to reflect on best practices and areas for system strengthening.

Step Up Together™ is an interdisciplinary, community-led program advancing safety and equity across the spectrum of maternity care.

This program provides quality improvement training and education across the primary maternity care ecosystem, which includes community-based care models, outpatient care, home-based care, community hospitals, critical access hospitals, emergency medical services, transport services, and community service agencies.

Step Up Together embodies Primary Maternity Care’s values and priorities as a leading QI experts and maternity care thought-leaders. These priorities include creating safe space and nurturing community; implementation efforts with clear goals and feedback loops; dynamic education and learner experiences; plus practical data collection, analytic and implementation tools.

Step Up Together is intentionally designed to be adaptable to all perinatal settings and care models, and includes a signature Community Debriefing – our structured collaborative process to surface and disseminate lessons learned across implementation sites.

As QI experts in this realm, we invite the broader health care system to step up to make every pregnancy safe – no matter the setting.

The Focused Action Cycle is a condensed version of the Step Up Together Action Collaborative.

Both programs use Step Up Together Drill Kits to support teams to run emergency drills involving transfer of care, and both programs feature Step Up Together’s signature Community Debrief session, where teams share insights and learnings from their drill experiences to maximize collective learning.

In the longer Action Collaborative, teams receive ongoing group coaching in a series of sessions over 5-6 months to gain the skills and support to plan, conduct, and debrief their emergency drill.

In a Focused Action Cycle, there are just two group coaching sessions: a Kickoff and a Community Debrief, and teams self-manage the steps of planning, although they can access one-on-one coaching if they need additional support during or after the cycle.

Step Up Together Faculty are available to provide additional coaching to teams that need support to plan, conduct, or debrief the drill or who want help translating their drill experience into actionable quality improvement initiatives.

Coaching topics include:

  • General Operations
  • General Clinical Support
  • Drill Planning Support
  • Eligibility and Transfer Guidelines Support
  • Transport Process Mapping and Review Support
  • Case Review Support

Contact stepup@primarymaternitycare.com to request a coaching appointment and inquire about fees.

The cost of an Action Collaborative typically ranges from $40,000, depending on the number of facilities involved and the specific clinical topic being addressed. This budget includes:

  • Seven monthly training sessions with coaching, instruction, and Q&A for hospital teams, community birth teams, and EMS members.
  • Drill Implementation Toolkits and program resources to support emergency transfer drills.
  • Faculty time for coaching and facilitation.
  • Access to impact data and reports for the sponsor’s internal use or quality improvement needs.
  • Additional costs may apply if in-person sessions are requested, such as faculty travel.


  • This pricing model is designed to maximize impact and ensure value across facilities, providing access to a comprehensive program at a reasonable per-participant cost. Any excess funds help grow the program and sustain its ongoing availability. We aim to secure funding from large-scale sponsors such as national organizations, ensuring accessibility for community providers and public health departments with limited resources.

    Yes, these drills can be adapted to diverse care settings, models of care, practice sizes, and levels of available time or resources. Whether your team is based in a small, community-based clinic, a large hospital, a birth center, or solo-practitioner home birth practice, Drill Kits are designed to be flexible and scalable to meet your needs.

    Smaller practices or those with limited resources use Partial Transfer Drills to hone their roles in key scenarios that are most relevant to their team, population or practice, while larger interdisciplinary teams can take advantage of Full Transfer Drills. In addition to adjusting the scale and scope of the drills, they can be customized to your practice’s model of care, whether it’s midwifery-led or physician-led, building up to an integrated team approach. You can also modify the timing to fit into your schedule, whether that means conducting shorter, focused drills during routine team meetings or staff orientations, or dedicating a longer period to cover more comprehensive simulations.

    In short, our drills are structured to accommodate real-world constraints while ensuring your team is better equipped to provide safe, effective care – all through improved team communication, preparedness, and coordinated response to emergencies.

    If you’re unsure how to best adapt these drills for your specific setting, we can provide guidance and resources to help you tailor the drills to your practice’s unique circumstance. Email us at team@stepuptogethernow.com for more information.

    An Action Collborative is well suited for community birth facilities, birth centers or home birth practices that have really good relationships with their hospitals AND those still working on establishing and improving those relationships.

    We recommend engaging in the program and starting to use the tools no matter where you are in the process.

    You can run a Partial Transfer Drill that takes place only in the community setting, and involves as few as 2 people. You may decide to make it part of your onboarding training.

    We will support you towards an eventual goal of a full transfer drill (and improved communication and collaboration with your facilities and other transport partners!) but many participants modify and adapt the tools for their current scenarios and settings.