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Obstetric hemorrhage remains the most common preventable cause of maternal death in Illinois. To improve safety and reduce mortality, the Illinois Department of Public Health (IDPH) developed the Obstetric Hemorrhage Education Project based on evidence provided by the Illinois Maternal Mortality Review Committee with input from obstetric providers, anesthesia providers, and perinatal nurses. Hospitals were required to measure resources and response times related to services critical to responding to obstetrical hemorrhage, such as turn-around times for laboratory tests, OR preparation, and availability of key personnel. 
By December 2009, all providers of care on obstetric units (including nurses, physicians, mid-level providers, such as midwives and CRNAs) must complete the training.  Ancillary personnel, such as clerks, nursing assistants, and technicians, must complete a modified version of the training program. The program has four components:

1. Benchmark Assessment (pretest)
   
2. Didactic lecture
   
3. Skills station with estimations of blood loss
   
4. Multidisciplinary simulation drill(s) with debriefing.
   

All members of the OB care team (including nursing assistants, technicians and clerical support) must participate in simulation drills, chosen from four sample situations that illustrate common hemorrhage scenarios. Although providers who practice at more than one hospital must complete the first three training components (benchmark assessment, lecture, skill station) only once, they must participate in multidisciplinary simulation drills at each hospital where they practice. This ensures that they learn to use systems that may be unique to each institution. Six months after training, participants complete a written posttest.
The Illinois Perinatal Network administers the program. At each hospital, the Director of Maternal Child Nursing identifies a doctor and nurse to act as implementation “Champions.” The Perinatal Network also facilitates training by providing supplies, coordinating expert speakers, and troubleshooting problems. In addition, hospitals were required to develop and train Rapid Response Teams to include maternity services. The project provides sample guidelines for the team’s composition, order sets, lists for emergency hemorrhage supply kits, and code flow sheets.