About FIMR
The purpose of the FIMR program is to understand how a wide array of social, economic, health, educational, environmental, and safety issues relate to infant loss on a local level. The goal is to enhance the health and well-being of women, infants, and their families through improved community resources and service delivery systems.
Indianapolis has a history of community collaboration to prevent infant mortality. The first infant mortality review was done in 1995 to 1997. Excellent data-based recommendations were made to improve maternal child health services. A large group of physicians, social workers, nurses, and other community agencies participated in the review process. Due to staff losses, the program continued on a limited basis. In 2004, the FIMR program restarted with a continuous quality improvement focus.
How FIMR Works
The FIMR Process begins when the program is notified that a fetal or infant death has occurred. The FIMR Program receives referrals from hospitals, clinics, vital records, case management programs, and other perinatal providers. FIMR staff contact parents through phone calls and home visits after the pregnancy loss or infant death. They provide emotional support, information, and referrals to other services that assist parents and families.
Records Review
The FIMR Program reviews information from various sources including medical records, birth and death certificates, and coroners’ reports. The FIMR Program is HIPAA compliant.
Parental Interview
The parental interview makes FIMR unique among other case review processes. The interview allows the parents’ voices to be heard and provides the opportunity to share their story by a home or phone interview.
Case Review Team (CRT)
The Case Review Team is the heart of the FIMR process!
A case summary is prepared using information from the parental interview and records review. The summary is de-identified to assure the confidentiality of patients, providers, and healthcare facilities. The case summary is then presented to the Case Review Team (CRT). This team represents a range of professions and public and private agencies that provide services and resources for women, infants, and families. The CRT reviews the summaries, examines the circumstances related to each case and identifies social, economic, health, educational, environmental, and safety factors associated with these deaths. The CRT then identifies strengths, information source issues, and contributing factors from each case. The CRT makes recommendations to improve maternal child health services and resources.
Community Action/Interventions
The next step in the FIMR process is to turn CRT recommendations into action. Specific work groups are assembled to implement interventions designed to address the problems identified by the CRT. Work group members include those who are in a position to direct change at the community level.
Community Action Team/Community Action Network (CAT/CAN)
The Community Action Team-Community Action Network (CAT-CAN) Organizational Chart shows the components of the CAT-CAN Network and how they work together to improve Marion County Maternal Health as well as Fetal and Infant Mortality.
Currently, the CAT/CAN team is working on the following recommendations:
- Improving maternal mental health in stress and anxiety and substance use disorder work groups
- Safe sleep work groups that include education directed to youth, moms, dads, and grandparents. We use the American Academy of Pediatrics (AAP) infant safe sleep guidelines.
Our Partner Organizations
Anthem, Ascension St. Vincent, BABE Store Program, Care Source, Community Health Network, Cradle Indy, DCS, Deliverance Tabernacle Church, Eskenazi Health, Fairbanks School of Public Health, Firefly Children and Family Alliance, Franciscan Health, Healthnet, Healthy Families, Indiana Black Breastfeeding Coalition, Indiana Department of Health, Indianapolis Healthy Babies Consortium, Indianapolis Healthy Start, Indiana Pregnancy Promise Program, Immigrant Welcome Center, Intouch Outreach, IU Health, IU School of Medicine, IU School of Nursing, Marion County Coroner’s Office, Marion County WIC, MDWise, Nurse Family Partnership, Raphael Health Center, Regenstrief Institute, RDoor Housing Corporation, Sandra Eskenazi Mental Health, Shades of Becoming a Mom, Six Dimensions, The Villages of Indiana