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Fetal-Infant Mortality Review

What is FIMR?

Emerging as a public health strategy in the mid-1980s, Fetal Infant Mortality Review (FIMR) was created as a response to the alarming increase in the infant mortality rate in the United States associated with adverse reproductive and infant health outcomes at the local level. Throughout the country, FIMR is being utilized as an action-oriented community process that continually assesses, monitors, and works to improve service systems and community resources for women, infants, and families.

By reviewing the circumstances surrounding the lives and deaths of these mothers and infants, as well as those who are never born (fetal deaths), and then providing these findings to community action teams (CAT), FIMR teams can come up with creative ideas to help improve birth outcomes and reduce infant mortality rates.  Research shows FIMR is an effective perinatal systems intervention as it examines infant mortality in the large context of social, economic and systems factors.

FIMR is:

  • Community-based
  • Action-oriented
  • Used at the local level to:
    • Assess
    • Plan
    • Improve, and
    • Monitor service systems
    • Develop policy
  • Promoting the health and well-being of women
  • A warning system that can describe effects of health care systems change
  • A method for implementing continuous quality improvement

How does FIMR work?

The FIMR process is not about assigning blame. Rather it is an examination of circumstances surrounding the death to identify system gaps. The FIMR process brings a multi-disciplinary community team together to review de-identified infant and fetal death cases. Composed of health, social service, medical, nursing and other professionals, the FIMR case review team examines the case summary, which is comprised of information from medical data abstractions, in conjunction with a maternal interview. Data sources will include birth and death certificates, records from hospitals and physicians, WIC, and Healthy Start. The case is discussed based on all information gathered and gaps in the systems of care are identified.

Findings are summarized and used to create recommendations to improve the community’s service delivery systems and resources. Community leaders representing government, consumer, key institutions and health & human services organizations serve on the CAT, which acts to implement recommendations. CATs can enhance the credibility and visibility of issues related to Hoosier parents, infants and families about the need for these actions through presentations, media events and written reports. By initiating new creative solutions for service delivery to families and constantly monitoring their applicability and effectiveness within the community, CATs work to improve the health outcomes of mothers and infants in communities.

FIMR can be used to bolster a variety of Indiana perinatal surveillance efforts. This can and should include the incorporation of FIMR findings into institutionalized Title V activities, such as the 5-year needs assessment and annually reported performance measures. Aside from the obvious positive potential impact on the informed, data-driven resource improvements in Indiana communities, FIMR is a valuable tool to enhance Indiana’s Title V Needs Assessment by:

  1. Examining social, cultural, safety, and health systems factors that are associated with fetal and infant mortality through review of individual cases
  2. Identifying systems barriers and problems that need improvement through case-reviews
  3. Including maternal interview information from consumers to further identify actions needed
  4. Addressing ways of improving service systems and community resources to reduce future fetal and infant deaths
  5. Providing valuable qualitative data to use with the state’s quantitative infant mortality data

http://www.babiesgonetoosoon.org
Babies Gone Too Soon aims to help families find hope, strength and support. The organization began when four mothers of angel babies came together to find a way to remember their babies. They offer financial support for funeral expenses, including fees for obituaries in newspapers.

www.postpartum.net/get-help/
The mission of Postpartum Support International is to promote awareness, prevention and treatment of mental health issues related to childbearing in every country worldwide. They offer online support groups, connections to licensed mental health professionals for weekly calls and emergency calls or text hotlines.

http://firstcandle.org/bereavement/online-support-groups/
First Candle’s peer-to-peer online support groups are a safe and supportive place for individuals and their families to share information and experiences surrounding pregnancy and infant loss. As a member, you can connect with other people experiencing grief, anger, anxiety and depression.

https://www.preeclampsia.org/get-support
The Preeclampsia Foundation seeks to reduce maternal and infant illness and death due to preeclampsia, HELLP syndrome, and other hypertensive disorders of pregnancy by providing patient support and education, raising public awareness, catalyzing research, and improving healthcare practices. Read about other women’s experiences with preeclampsia and add your story, too.

https://nationalshare.org
The mission of Share Pregnancy and Infant Loss Support, Inc. is to serve those whose lives are touched by the tragic death of a baby through pregnancy loss, stillbirth, or in the first few months of life.

www.unspokenstories.org
Honest stories of pregnancy, parenthood and loss are too often unshared. Let’s tell the real story. Let’s build a supportive community that gives voice to your experience, from the joys of parenting to the heartbreak of loss.


View resources for clinicians

County and Regional FIMR Teams

Select a county to view local FIMR Team information, if applicable.

fimr logo


Contact

Linzi Horsley
Fetal-Infant Mortality Programs Director
Indiana Department of Health, Division of Fatality Review and Prevention
317-509-4119, lhorsley@health.in.gov

Olivia Gonzalez
Northern IN FIMR Coordinator
ogonzalez@health.in.gov

Melanie Pote
Southern IN FIMR Coordinator
mpote@health.in.gov

County Name Here

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

Bartholomew County FIMR

Columbus Regional Health

Point of Contact

Patty Pigman
ppigman@crh.org

Grant County Regional FIMR

Marion Health System

Point of Contact

Abby Flenar
abby.flenar@marionhealth.com

Gail Elbert
gail.elbert@marionhealth.com

Cindy Futrell
cindy.futrell@marionhealth.com

West Central IN FIMR

Tippecanoe County Health Department

Point of Contact

Aubrey Kitchel
akitchel@tippecanoe.in.gov

South-Central Regional FIMR

IU Health Community Health

Point of Contact

Emily Bock
ebock1@iuhealth.org

West Central IN FIMR

Tippecanoe County Health Department

Point of Contact

Aubrey Kitchel
akitchel@tippecanoe.in.gov

Cass County Regional FIMR

Logansport Memorial Hospital

Point of Contact

Trista Green
tgreen@logansportmemorial.org

Kim Flora
kflora@logansportmemorial.org

Angie Soupley
asoupley@logansportmemorial.org

Clark County Regional FIMR

LifeSpring Health System

Point of Contact

Breeze Peele
breeze.peele@lifespringhealthsystems.org

Wabash Valley FIMR

Richard G. Lugar Center for Rural Health - Union Hospital

Point of Contact

Heather Anderson
heaanderson@uhhg.org

West Central IN FIMR

Tippecanoe County Health Department

Point of Contact

Aubrey Kitchel
akitchel@tippecanoe.in.gov

Daviess County Regional FIMR

Daviess Community Hospital

Point of Contact

Desiree' Lewis - FIMR Coordinator
dlewis@dchosp.org

Shawna O'Kelley Brinson, RN - OB/Nursery Director
sokelley@dchosp.org

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

Southeastern IN FIMR

Vanderburgh County Health Department

Point of Contact

Bonnie Miller 
bmiller@vanderburghcounty.in.gov

Lynn Herr
lherr@vanderburghcounty.in.gov

Elkhart County FIMR

Elkhart County Health Department

Point of Contact

Andrew Bylsma
abylsma@elkhartcounty.com

Melanie Sizemore
msizemore@elkhartcounty.com

East Central IN FIMR

Wayne County Health Department

Point of Contact

Cynthia Blue
cblue@co.wayne.in.us

Halley Lilley
hlilley@co.wayne.in.us

Clark County Regional FIMR

LifeSpring Health System

Point of Contact

Breeze Peele
breeze.peele@lifespringhealthsystems.org

Cass County Regional FIMR

Logansport Memorial Hospital

Point of Contact

Trista Green
tgreen@logansportmemorial.org

Kim Flora
kflora@logansportmemorial.org

Angie Soupley
asoupley@logansportmemorial.org

Southeastern IN FIMR

Vanderburgh County Health Department

Point of Contact

Bonnie Miller 
bmiller@vanderburghcounty.in.gov

Lynn Herr
lherr@vanderburghcounty.in.gov

Grant County Regional FIMR

Marion Health System

Point of Contact

Abby Flenar
abby.flenar@marionhealth.com

Gail Elbert
gail.elbert@marionhealth.com

Cindy Futrell
cindy.futrell@marionhealth.com

South-Central Regional FIMR

IU Health Community Health

Point of Contact

Emily Bock
ebock1@iuhealth.org

Harrison County FIMR

Harrison County Health Department

Point of Contact

Theresa Buechele
tbuechele@harrisoncounty.in.gov

East Central IN FIMR

Wayne County Health Department

Point of Contact

Cynthia Blue
cblue@co.wayne.in.us

Halley Lilley
hlilley@co.wayne.in.us

Howard County FIMR


Point of Contact

Jennifer Sexton
jennifer.sexton@howardcountyin.gov

Brenda Parker
brenda.parker@howardcountyin.gov

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

Northwestern IN FIMR

Franciscan Health

Point of Contact

Bernadette Taylor
bernadette.taylor@franciscanalliance.org

Jackie Carter
jackie.carter@franciscanalliance.org

Jennings County FIMR

Jennings County Health Department

Point of Contact

Patty Pigman
ppigman@crh.org

Knox County FIMR

Good Samaritan Hospital

Point of Contact

Jessica Thompson
jthompson1@gshvin.org

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

Northwestern IN FIMR

Franciscan Health

Point of Contact

Bernadette Taylor
bernadette.taylor@franciscanalliance.org

Jackie Carter
jackie.carter@franciscanalliance.org

LaPorte County FIMR

LaPorte County Health Department

Point of Contact

Peggy Rose
prose@laporteco.in.gov

South-Central Regional FIMR

IU Health Community Health

Point of Contact

Emily Bock
ebock1@iuhealth.org

Madison County FIMR

Madison County Health Department

Point of Contact

Holly Leech
hleech@madisoncounty.in.gov

Sarah Neal
sneal@madisoncounty.in.gov

Marion County - Indianapolis Healthy Babies FIMR

Marion County Public Health Department - Indianapolis Healthy Babies

Point of Contact

Teri Conard
tconard@marionhealth.org

Daviess County Regional FIMR

Daviess Community Hospital

Point of Contact

Desiree' Lewis - FIMR Coordinator
dlewis@dchosp.org

Shawna O'Kelley Brinson, RN - OB/Nursery Director
sokelley@dchosp.org

Cass County Regional FIMR

Logansport Memorial Hospital

Point of Contact

Trista Green
tgreen@logansportmemorial.org

Kim Flora
kflora@logansportmemorial.org

Angie Soupley
asoupley@logansportmemorial.org

South-Central Regional FIMR

IU Health Community Health

Point of Contact

Emily Bock
ebock1@iuhealth.org

South-Central Regional FIMR

IU Health Community Health

Point of Contact

Emily Bock
ebock1@iuhealth.org

Northwestern IN FIMR

Franciscan Health

Point of Contact

Bernadette Taylor
bernadette.taylor@franciscanalliance.org

Jackie Carter
jackie.carter@franciscanalliance.org

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

South-Central Regional FIMR

IU Health Community Health

Point of Contact

Emily Bock
ebock1@iuhealth.org

South-Central Regional FIMR

IU Health Community Health

Point of Contact

Emily Bock
ebock1@iuhealth.org

Wabash Valley FIMR

Richard G. Lugar Center for Rural Health - Union Hospital

Point of Contact

Heather Anderson
heaanderson@uhhg.org

Daviess County Regional FIMR

Daviess Community Hospital

Point of Contact

Desiree' Lewis - FIMR Coordinator
dlewis@dchosp.org

Shawna O'Kelley Brinson, RN - OB/Nursery Director
sokelley@dchosp.org

Porter County FIMR

Porter County Health Department

Point of Contact

Hayley Gerstler
Hayley.Gerstler@porterco.org

Southeastern IN FIMR

Vanderburgh County Health Department

Point of Contact

Bonnie Miller 
bmiller@vanderburghcounty.in.gov

Lynn Herr
lherr@vanderburghcounty.in.gov

Cass County Regional FIMR

Logansport Memorial Hospital

Point of Contact

Trista Green
tgreen@logansportmemorial.org

Kim Flora
kflora@logansportmemorial.org

Angie Soupley
asoupley@logansportmemorial.org

East Central IN FIMR

Wayne County Health Department

Point of Contact

Cynthia Blue
cblue@co.wayne.in.us

Halley Lilley
hlilley@co.wayne.in.us

East Central IN FIMR

Wayne County Health Department

Point of Contact

Cynthia Blue
cblue@co.wayne.in.us

Halley Lilley
hlilley@co.wayne.in.us

Clark County Regional FIMR

LifeSpring Health System

Point of Contact

Breeze Peele
breeze.peele@lifespringhealthsystems.org

Shelby County FIMR


Point of Contact

Amy Reel
areel@shelbyhealthindiana.com

Denise Holland
dholland@majorhospital.org

St. Joseph County FIMR

Beacon Health System

Point of Contact

Sally Dixon, RN, BA - FIMR Coordinator
sadixon@beaconhealthsystem.org

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

Wabash Valley FIMR

Richard G. Lugar Center for Rural Health - Union Hospital

Point of Contact

Heather Anderson
heaanderson@uhhg.org

West Central IN FIMR

Tippecanoe County Health Department

Point of Contact

Aubrey Kitchel
akitchel@tippecanoe.in.gov

Grant County Regional FIMR

Marion Health System

Point of Contact

Abby Flenar
abby.flenar@marionhealth.com

Gail Elbert
gail.elbert@marionhealth.com

Cindy Futrell
cindy.futrell@marionhealth.com

East Central IN FIMR

Wayne County Health Department

Point of Contact

Cynthia Blue
cblue@co.wayne.in.us

Halley Lilley
hlilley@co.wayne.in.us

Southeastern IN FIMR

Vanderburgh County Health Department

Point of Contact

Bonnie Miller 
bmiller@vanderburghcounty.in.gov

Lynn Herr
lherr@vanderburghcounty.in.gov

Wabash Valley FIMR

Richard G. Lugar Center for Rural Health - Union Hospital

Point of Contact

Heather Anderson
heaanderson@uhhg.org

Wabash Valley FIMR

Richard G. Lugar Center for Rural Health - Union Hospital

Point of Contact

Heather Anderson
heaanderson@uhhg.org

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

Warren County FIMR

Warren County Health Department

Point of Contact

Breanna Blackburn
vitalrecords@warrencounty.in.gov

Laci Frodge
healthadministrator@warrencounty.in.gov

Southeastern IN FIMR

Vanderburgh County Health Department

Point of Contact

Bonnie Miller 
bmiller@vanderburghcounty.in.gov

Lynn Herr
lherr@vanderburghcounty.in.gov

Clark County Regional FIMR

LifeSpring Health System

Point of Contact

Breeze Peele
breeze.peele@lifespringhealthsystems.org

East Central IN FIMR

Wayne County Health Department

Point of Contact

Cynthia Blue
cblue@co.wayne.in.us

Halley Lilley
hlilley@co.wayne.in.us

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

West Central IN FIMR

Tippecanoe County Health Department

Point of Contact

Aubrey Kitchel
akitchel@tippecanoe.in.gov

Northeastern IN FIMR

Parkview Health

Point of Contact

Britte Nihart
britte.nihart2@parkview.com

Alaina Schultz
alaina.schultz@parkview.com

Stephanie Gehring
stephanie.gehring@parkview.com

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