Fetal and Infant Mortality Review or FIMR
Fetal and Infant Mortality Review or FIMR is a process that brings together key members of the community to review information from individual cases of fetal and infant death to determine whether systems’ problems contributed to the death. Traditionally most communities have identified the medical causes of mortality, but there has not been a system that allows communities to comprehensively examine existing societal and system problems which affect mortality during the first year of life.
The Fetal and Infant Mortality Review (FIMR) process has emerged as a methodology that affords a close look at everything that affects the health of the mother, the fetus, and the infant. They key steps in the FIMR process are:
- Information about the death is gathered. Sources include public health and medical records.
- An interview with the mother who has suffered the loss is conducted, if the mother agrees.
- The Case Review Team composed of health, social service and other experts from the community review this summary of case information and the interview, identify issues and make recommendations for community change, if appropriate.
- The Community Action Team, a diverse group of community leaders, review Case Review Team recommendations, prioritize identified issues, then design and implement interventions to improve services systems and resources.
- Confidentiality of all information is strictly maintained. This means the names of the mother, provider and institution are removed.
Seventeen counties in South Carolina have FIMR groups. Depending
on the caseload, these groups meet monthly or quarterly. In addition,
some counties have a group called "Perinatal Issues." These
counties discuss issues around fetal and infant deaths in their communities
but do not do the formal medical record reviews of the deaths.
Over the years, local FIMR groups have implemented several actions which include:
- Improved community bereavement services;
- Promoted SIDS risk reduction activities;
- Reduced gaps in prenatal and/or pediatric services;
- Conducted media campaigns;
- Developed patient education material;
- Implemented domestic violence screening and treatment;
- Increased collaboration among community service organizations; and
- Improved transportation to service sites.
The state FIMR programs are linked to the National Fetal and Infant Mortality Review Program (NFIMR) which funds demonstration projects, provides training and technical assistance, and develops resources.