Perinatal Quality Collaboratives (PQCs) exist to turn evidence into action so maternal and infant health care gets safer and more equitable. The National Network of PQCs (NNPQC) and the CDC describe PQCs as state or multi-state networks that rapidly improve care through data-guided implementation.
After more than a decade of focus on hospital-based preparedness, there is now a national movement to strengthen system-wide readiness for perinatal emergencies. This shift is reflected in the new AIM Community Birth Transfer Resource Kit, ACOG guidance for obstetric emergencies in non-obstetric settings, and CMS policies requiring critical access hospitals to prepare for obstetric and neonatal emergencies.
Step Up Together® – a program from Primary Maternity Care (PMC) – is built for exactly these purposes: ready-to-use tools, coaching, and a cross-setting community that help teams run inter-facility emergency transfer drills and install sustainable system fixes.
Read on to see why partnerships between PQCs and Primary Maternity Care, like ongoing partnerships in California and Louisiana, are a powerful way to align efforts and drive meaningful change.
Direct Alignment with PQC Goals
Step Up Together maps cleanly onto widely shared PQC priorities.
Training, education, and continuous quality improvement (QI)
Step Up Together couples plug-and-play tools with coaching and a peer community, so sites move from trainings to iterative test-and-learn cycles with structured debriefs and action plans. We can partner with PQCs to provide simulation and team training, standardization to reduce variation, quality and safety consulting on safety protocols, and structured programs that operationalize evidence-based practices.
Step Up Together Action Collaboratives spark quality improvement projects that make care safer and more seamless, such as policy updates and interdisciplinary training. Examples from real Step Up Together participant teams include co-development of streamlined documentation processes, emergency department protocols for admission to labor and delivery or the NICU, and more.
“As a team, we plan to do our own drills more often, using the resources provided.”
– Louisiana Step Up Together attendee
Birthing facilities closing / rural access
With rural OB closures and the increase in “maternity deserts,” states are seeking pragmatic ways to protect patients amidst closures. Standardized transfer pathways and full-scale drills are essential. Step Up Together strengthens those pathways—an approach highlighted for supporting rural maternal care and community-hospital integration.
Better collaboration with EMS & emergency departments
A growing priority nationally, engagement with emergency care providers and non-obstetric setting to improve care for mothers and infants has become an important focus area for PQCs. Step Up Together coaches on EMS engagement, information handoff, and ED and hospital receiving processes, allowing for practice together before emergencies occur. Our experiences running drills has exposed key areas of collaboration and improvement for EMS agencies and personnel and hospital emergency department processes.
“We are loving this opportunity to engage with EMS and local hospitals – so helpful!”
– California Step Up Together participant
Operationalizing AIM Patient Safety Bundles
Whether your PQC is emphasizing community birth integration, OB emergencies (e.g., hemorrhage, severe hypertension), or other clinical AIM bundle topics, the drills and checklists operationalize Readiness-to-Response across all locations of care, including community-to-hospital transfers. Resulting QI projects often map directly onto the Three Delays framework, a proven lens for understanding barriers to safe and timely care.
The Step Up Together program has also been featured on ACOG’s AIM for Safer Birth podcast, underscoring alignment with national safety priorities.
“Great program! Drill kit is very easy to use. I enjoyed working with the teams!”
– California Step Up Together drill participant
Customizable, Evidence-based, and Interdisciplinary
Customizable to your state’s focus areas
Step Up Together provides Drill Kits and implementation support that states can tailor to local realities. Teams can choose intrapartum, postpartum, or neonatal scenarios and adapt roles, policies, and transfer pathways to regional needs.
Grounded in national results
The 2024 Step Up Together Action Collaborative—the first program of its kind to equip teams for interdisciplinary, inter-facility emergency transfer drills among birth centers, EMS, and hospitals—showed strong feasibility, improved teamwork/communication, and immediate QI changes in documentation, EMS engagement, and equipment readiness. Read more in our 2025 article in the Journal of Midwifery & Women’s Health.
Interdisciplinary by design
The program convenes community midwives and birth centers with EMS, emergency departments, hospital L&D/NICU nurse and physician teams, and clinics, which is cross-setting collaboration that PQCs aim to normalize.
Ready-to-Implement and Built for Sustainable Change
PQCs need solutions their participating sites can actually deploy. Step Up Together delivers:
- Turnkey Drill Kits for high-yield scenarios (e.g., immediate postpartum hemorrhage with transport) with roles, prompts, checklists, debrief guides, and report forms.
- Coaching and community to unblock logistics, adapt for local contexts, and sustain change across cohorts.
- A proven, scalable model already used by interdisciplinary dyads and recognized by national partners focused on community birth integration, infrastructure and workforce development, patient safety, and rural health care.
- Supplemental resources for hospitals and health systems to speed policy alignment, documentation standards, and warm handoff processes. PMC conducts research and analyses, issuing guidance on care model integration such as the Hospital Guide to Integrating the Freestanding Birth Center Model and the Connecticut Doula Integration Toolkit.
Intrigued? Let’s Talk!
If this all sounds like it might be a fit for your PQC, fill out the contact form below! We can setup a time to meet and talk about your PQC’s specific interests, answer questions about our program, and explore possibilities. We’ll create a proposal tailored to your state’s needs.
