OPQIC

This form is intended to collect hospital commitment to participate in the first phase of the Oklahoma Maternal Addiction and Mental Health Assistance (OK-MAMA) initiative, Respectful Maternity Care.

Regarding the Spotlight Hospital Award, hospitals uploading the commitment letter by September 14, 2026 will receive 3 points and hospitals completing the Implementation Team fields and the Baseline Question fields will receive an additional 3 points.

Hospitals not submitting the commitment letter by September 14 will still have the option to participate, but will not receive any points toward the Spotlight Hospital Award.
Hospital
Participation Agreement*
- Yes, our organization will commit to participate in the first phase of OK-MAMA, Respectful Maternity Care. We understand that our participation will begin sometime in late 2026 with future meetings to be announced.
Upload Signed Commitment Letter*
Max. file size: 512 MB.

Upload a signed version of the commitment letter that can be found at https://opqic.org/ok-mama/commitment. Please include part of your hospital name or initials in the file name.
Please complete the contact fields below for those involved in your implementation team. Some individuals may fill more than one role. The Main Contact, Nursing Implementation Leader, Provider Implementation Leader and Executive Leader are required fields.

We understand that this may not be a final list – your team may evolve as we progress through the initiative.
Main Hospital Contact for OK-MAMA*
This is the person that will be responsible for receiving most of the communication regarding the initiative.
Full Name Credentials (MD, DO, RN, etc) Job Title
Main Contact Email Address*
For the fields below, use the + button to the right if you have more than one member in each role.
Nurse Implementation Leader(s)*
Name Credentials Job Title email
Provider Implementation Leader(s)*
Name Credentials Job Title email
Executive Sponsor(s)*
Name Credentials Job Title email
Data Submission Leader(s)
Name Credentials Job Title email
Social Worker(s)
Name Credentials Job Title email
Champion(s)
Name Credentials Job Title email
Other(s)
Name Credentials Job Title email
Baseline Data Question
As of August 31, 2026, what cumulative proportion of OB clinicians† has received, in the last two years, education on respectful and equitable care?
(See below for definition of “clinicians” and list of educational resources that would be considered as meeting this measure)
- 0 to 9%
- 10% to 19%
- 20% to 29%
- 30% to 39%
- 40% to 49%
- 50% to 59%
- 60% to 69%
- 70% to 79%
- 80% to 89%
- 90% or greater
†The overarching intention of this measure is to capture all clinicians who work in a primarily inpatient OB service line or on an L&D, Antepartum, Postpartum unit. These clinicians will likely be interdisciplinary and could be inclusive of, but not limited to, nurses and nurse managers, advance practice nurses, nurse midwives, physician associates, and Family Medicine physicians or other specialties with delivering privileges at your institution.
Category 1: Core RMC Resources
- *NICHQ RMC Toolkit
- *CDC Foundation RMC Resources
- *White Ribbon Alliance
- *WHO RMC materials
- *FIGO RMC materials
- *ICM RMC materials
Category 2: Supporting RMC Education
- *AIM
- *TeamBirth
- *OPNF Perinatal Nursing Boot Camp
- *AWHONN
- *ACNM
- *ACOG
- *AHRQ SPPC
- *Hear Her® Campaign

Name	Credentials	Job Title	email

Name	Credentials	Job Title	email

Name	Credentials	Job Title	email

Name	Credentials	Job Title	email

OK-MAMA Commitment Form