About the Bundle
The national maternal safety bundles have primarily been focused on the inpatient setting. Recognizing the need to extend these protections beyond the hospital, this work has been adapted as the “Outpatient Severe Hypertension Bundle”.
About This Tool
We have studied this tool extensively and have adapted it across several contexts to best meet the needs of our users.
How to Use This Website
This website provides resources and guidance to support maternal safety practices. Here you will find evidence-based bundles, educational materials, and implementation tools to help improve outcomes. Below you will find that we have adapted these materials in a Clinical Practice Bulletin for the outpatient setting:
Readiness
Having the systems, protocols, and teams in place before a crisis occurs. Every outpatient care setting should establish the foundational processes below.
How to use this section
What is readiness?
What you will find in this section
Resources and materials designed by our team to support readiness implementation.
Recognition & Prevention
Identifying severe hypertension early and ensuring every patient has the knowledge and tools to recognize warning signs — before a crisis occurs.
How to use this section
What is recognition & prevention?
Response
Every case of severe hypertension should be managed using a standardized protocol — ensuring consistent, timely, and patient-centered care at every encounter.
How to use this section:
What is Response?
Every encounter should be led with patient-centered, respectful care in mind
What you will find in this section:
Resources and materials designed by our team to support standardized response in your outpatient setting.
- Response protocols
- Clinical algorithms
- Treatment guidelines
- Transfer resources
Reporting & Systems Learning
Every Clinic should build a culture of continuous learning- reviewing cases, identifying systems issues, and monitoring outcomes to drive equitable ongoing improvement.
How to use this section:
What is reporting & systems learning?
What you will find in this section:
Resources and materials designed by our team to support reporting and systems learning in your outpatient setting.
Respectful & Supportive Care
Every team member and every clinic should center patients and their support networks in care — building trust, reducing barriers, and ensuring equitable, informed decision-making at every encounter.
How to use this section:
What is respectful & supportive care?
What you will find in this section:
Resources and materials designed by our team to support respectful and supportive care in your outpatient setting.
Practice Bulletin References
Hypertension Practice Bulletin Resources References:
- MSc JEM, Mph AVM, Pettker CM, Simhan AH. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. American College of Obstetricians and Gynecologists. 2020 Jun 6;135(6): e237–60.
- Paul G. Schmitz TN. Hypertension, Clinical Updates in Women’s Health Care. American College of Obstetrics and Gynecology. 2016
- AIM PATIENT SAFETY BUNDLES [Internet]. ALLIANCE FOR INNOVATION ON MATERNAL HEALTH. 2021. Available from: https://saferbirth.org/psbs/severe-hypertension-in-pregnancy/
- Pregnancy Mortality Surveillance System [Internet]. CDC Centers for Disease Control and Prevention. 2022. Available from: https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm
- Howell E et al. Reduction of Peripartum Racial and Ethnic Disparities: A Conceptual Framework and Maternal Safety Consensus Bundle. Journal of Midwifery & Women’s Health. 2019 May;63(3):353.
- HEAR HER Campaign [Internet]. CDC Centers for Disease Control and Prevention. 2022. Available from: https://www.cdc.gov/hearher/index.html
- California Collaborative on District Reform. Available from: https://cacollaborative.org/
