CALM Quality Improvement Program & Complementary Initiatives

The aim of CALM’s Quality Improvement Program is to support CALM midwife members and further the autonomy of the licensed midwife profession by improving practice and outcomes.

In 2018 the California legislature added licensed midwives to the list of health care professionals with statutorily protected peer review.

The provision was added to the Medical Board Sunset review bill that year at the request of California Association of Licensed Midwives, so that CALM could offer its members a Quality Improvement Program. Protected peer review is the foundation of quality improvement, case review and peer review.

Subsequently, in collaboration with California College of Midwives, CALM was able to pilot an incident review process to support midwives wanting to make improvements in their practice.

The incident review process includes:

  • Midwife self-report when there is a sentinel event or circumstances where the midwife desires a formal review by midwife peers (sample report here from MAWS)
  • After initial review, the midwife and reviewers decide if the case warrants further review
  • Subsequently, the midwife receives feedback from reviewers on areas of improvement that can be made, when applicable

Community Midwife Peer Review

Having been left out of research grant funding, legislative initiatives for health services integration, public education, educational loan programs, -- systemically overlooked by policy makers -- licensed midwives have taken the provision of professional care into their own hands. That includes engaging in professional peer review in their communities where they live and work. Peer review is required of both Certified Professional Midwives and California Licensed Midwives. As the majority of licensed midwives are independent self-employed health care providers, they form peer review groups local to where they practice -- sometimes traveling great distances in rural areas to spend a full day in peer review with their fellow midwives.

Other key aspects of the CALM Quality Improvement Initiative

CALM Transitions: a multi-stakeholder initiative to improve inter-professional education and communication – based on a World Health Organization framework -- among community midwives, emergency medical personnel and hospital providers. If you are a midwife working in your community to improve education and communication with local hospital providers, inquire at info@calmidwives.org to receive tools to support your efforts. The toolkit includes a PowerPoint ready to go for facilitating your relationship building and improving transfers through education and training.

Standardized quality care feedback:  a standardized form that midwives can give to their clients in order to provide feedback to the midwife about their experience receiving care form the midwife and in the event of a transfer, to the hospital and hospital staff.

Standardized forms, informed consent documents and chart forms (work in progress to be available in 2022).

Practice guidelines

Continuing education focused on improving outcomes and engaging in quality improvement, individually, regionally and state wide.

CALM invites community engagement in this process. If you are a midwifery client invested in quality midwifery care, please drop us an email to either give feedback or to join the quality improvement team. info@calmidwives.org

CALM midwife members may contact the program at info@calmidwives.org for more information, to volunteer on the committee and to access forms.

Give direct and helpful feedback to your licensed midwife and allied healthcare team

In order to support licensed midwives and allied healthcare providers in making on-going improvement for outcomes, quality and care satisfaction feedback is necessary from clients. Download the quality evaluation form as needed for you to give YOUR licensed midwife direct feedback for excellent care and for areas of needed improvement. Or get the form directly from your CALM member midwife/midwives.

Also, if you had interaction with other allied health care providers or experienced a transfer you can also use the CALM Transfer or Collaborative Care Feedback Form provided here [in development].

How to File a Complaint

CALM is aware that some healthcare providers, consumers, or family members may have concerns about the care provided by a licensed midwife who is also a CALM member. Any patient, client, family member, healthcare provider, allied birth professional, or facility may file a complaint against one of our midwives to the Quality Management Program (QMP). Click here to download the Complaint Form. Please be aware that a review of the event in question requires contacting the midwife and reviewing the chart notes, and therefore we cannot maintain client anonymity.  The QMP upholds the highest standards of confidentiality and safety.  Because of this very commitment to confidentiality, complainants will not receive any information about the results of such a review. ​

Once a complaint is received, the QMP Committee reviews the information and begins a review if the case meets criteria for further inquiry. Review panels are convened and the findings are reported back to the CALM QMP committee. If any laws have been broken we are obligated to notify the Medical Board of California

As a statewide midwifery organization, we appreciate your feedback in order to identify practice trends or any gaps in education. We organize annual continuing education for our members based partly on incident and peer review data. CALM members are committed to the continuous improvement of maternity care services in California.