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Maternal & Child Health Epidemiology

Fetal Infant Mortality Review (FIMR)

Fetal Infant Mortality Review (FIMR)

The New Jersey (NJ) Fetal Infant Mortality Review (FIMR) program is a statewide multi-disciplinary, multi-agency, community-based team that seeks to improve fetal and infant outcomes in NJ.

The New Jersey Department of Health (NJDOH) has agreements in place with three Maternal and Child Health Consortia (MCHCs) to conduct Fetal-Infant Mortality Reviews (FIMRs) at the regional level across all counties within their respective catchment areas. The three organizations that comprise the MCHC are:

The case review process is designed to elucidate the factors contributing to fetal and infant mortality. The approach is both systematic and community-specific, and is based on key activities:

  1. Ensure comprehensive data integrationby securing access to essential clinical and non-clinical data sources pertinent to fetal and infant care. Linking data from various sources helps curate a comprehensive, holistic picture of each case reviewed.
  2. Host family conversations by conversing with families and support persons who consent to participate in the project, which allows the review team to gain insights into the circumstances surrounding each fetal or infant death outside of the medical records and reports. This process further humanizes the case.
  3. Promote community-specific interventions by guiding the design and implementation of important public health initiatives that are customized to address the unique needs and challenges identified (e.g., Safe Sleep campaign).
  4. Maintain consistency in case selection by implementing the Perinatal Period of Risk protocol, which standardizes case identification and reviews based on key health and social indicators. Using this strategic approach, the FIMR program aims to understand the root causes of fetal and infant mortality and to generate meaningful, data-driven recommendations in maternal and child health throughout New Jersey.
  5. Ensure strict confidentiality by maintaining rigorous legal protections to safeguard the confidentiality of all data, records, and findings, upholding the privacy and trust of those involved.

 

FIMR Model

The Fetal and Infant Mortality Review (FIMR) model is based on a national framework that emphasizes the community's vital role in the review process. This model involves two separate multidisciplinary groups, each with a specific role in improving fetal and infant health outcomes.

  1. The Case Review Team (CRT):
    • The CRT functions as the "information processor.” The CRT conducts comprehensive reviews of fetal and infant mortality cases.
    • The CRT analyzes data, identifies patterns, determines the underlying causes and contributing factors related to these mortality cases, and makes recommendations on how to prevent future deaths.

  2. The Community Action Team (CAT)
    • The CAT leverages the detailed findings, insights, and recommendations provided by the CRT to propose and develop actionable strategies.
    • The CAT is responsible for strategically crafting and leveraging action-based initiatives designed to inform policies and public health interventions.
    • The CAT aims to address systemic issues within their communities, with the goal of improving fetal and infant health outcomes both locally and potentially statewide.

 

State Resources

National Resources