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"Identifying the specific level of care available at each hospital allows the sickest patients to make sure they are in the right place."

Perinatal levels of care: Resources

Watch this recorded Webinar: Leveling the Field - Completing the WAPC Levels of Care Self-Assessment Survey Without Pain


Self-Assessment Materials

The following list includes all of the necessary documents an institution will need to complete the self-assessment.

To use the PDFs below as fillable forms, you will need Adobe Acrobat Reader, Version XI.

Self-Assessment Instruction Sheet
Application Form (This form is REQUIRED.)

Level I Obstetric Services Self-Assessment Survey
Level II Obstetric Services Self-Assessment Survey
Level III Obstetric Services Self-Assessment Survey
Level IV Obstetric Services Self-Assessment Survey

Level I Neonatal Services Self-Assessment Survey
Level II Neonatal Services Self-Assessment Survey
Level III Neonatal Services Self-Assessment Survey
Level IV Neonatal Services Self-Assessment Survey

Appendix: Staffing Ratios Worksheet

Supplemental Surveys
The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) published updated recommendations for obstetric levels of care in February 2015. If you completed an Obstetric Level of Care survey prior to October 2015, the survey you completed did not reflect the most recent changes. You are invited to update your self-assessment survey by completing the appropriate supplemental survey below.

References

  • American Academy of Pediatrics, American College of Obstetricians and Gynecologists. Guidelines for Perinatal Care, 7th Edition. 2012. Elk Grove Village, IL/Washington, DC:AAP/ACOG.
  • American Academy of Pediatrics Committee on Fetus and Newborn. Levels of Neonatal Care. Pediatrics. 2004;114(5):1341-1347.
  • American Academy of Pediatrics Committee on Fetus and Newborn. Levels of Neonatal Care. Pediatrics. 2012;130(3):587-597.
  • American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine, Menard MK, et al. Levels of Maternal Care. Am J Ob Gyn. 2015;212(3):259-271.

Recommendation for developing a guideline or policy regarding consultations for the care of high-risk pregnant women

Levels of Care Summary. This document provides a brief summary of the obstetric and neonatal levels of care.

Neonatal Levels of Care Comparison Chart

Guidelines for the Responsible Utilization of Neonatal Intensive Care
This paper offers practical guidelines for institutional policies and procedures for the responsible use of neonatal intensive care. The paper is intended for health care providers, parents, and administrators, and the information may also be relevant to those interested in the range of clinical, social, ethical, and economic issues that neonatal intensive care presents. 

Guide for Parents
WAPC developed a guide for parents and other consumers that describes the Levels of Care Initiative. The guide was developed jointly with the Wisconsin Hospital Association to provide consumers with information about the CheckPoint measure related to level of care provided by hospitals. Levels of Care: A Guide for Parents