If you’re considering joining a Step Up Together Action Collaborative—or encouraging your hospital or community partner to do so—you might be wondering: what does participation actually look like? The short answer: it’s a structured, time-limited commitment with real benefits for your team and your patients. The longer answer is that there’s a rhythm to the
There’s nothing quite like the power of a large, truly interdisciplinary Full Transfer Drill. One Massachusetts participant recently reflected: That drill brought together area home birth midwives, EMS providers, hospital team members from multiple departments, hospital administrators, and Department of Public Health officials—an extraordinary example of what it looks like when a whole system shows
In the wake of historic maternal health legislation providing greater access to community midwifery and doulas, the Massachusetts Department of Public Health embarked on and funded a collaborative process to implement system-wide change to fully integrate these care models into the healthcare system. A major part of this effort has involved making community-specific plans for
When an emergency happens in a community birth setting, every minute counts. In Step Up Together, we use the 3 Delays Framework to help teams identify and address the most common barriers to safe, timely, and respectful transfers from home or birth center to hospital care. The 3 Delays model has been used worldwide to
Full Transfer Drills are one of the most powerful tools for strengthening community-to-hospital transfer processes. They don’t just test logistics, they spark lasting quality improvement (QI) projects that make care safer and more seamless. Through the Step Up Together® Action Collaborative, we’ve seen clear patterns in the kinds of QI projects that emerge. These projects often map directly onto the Three Delays framework, a proven lens for understanding barriers to safe and timely care.
Hospitals across the country are grappling with how to engage more meaningfully with community-based care models. Whether you’re navigating growing demand for out-of-hospital options, responding to calls for equity and respectful care, or just trying to ensure smoother transfers from home or birth center births, one thing is clear: integration doesn’t happen overnight. But that
In community birth settings like birth centers and home birth practices, emergencies are rare—but when they happen, everyone needs to be ready. That’s why interdisciplinary emergency drills are so critical: they help teams practice protocols, build trust across settings, and make life-saving decisions more efficient under pressure. At Step Up Together, we’ve seen firsthand how
We’re proud to share that new national guidelines for fetal assessment using intermittent auscultation (IA) in community birth settings have just been published in Birth: Issues in Perinatal Care. These midwifery-led, peer-reviewed guidelines mark a critical step toward strengthening safety, clarity, and collaboration in home and birth center birth. The new guidelines were developed through
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