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Levels of Care Self-Assessment

Levels of Care Self-Assessment Initiative

About the Initiative
The Wisconsin Association for Perintal Care (WAPC) has adopted levels of care criteria based on recommendations released by the American Academy of Pediatrics (AAP).

WAPC is asking that all Wisconsin hospitals that provide perinatal care services complete a level of care self-assessment. Through the self-assessment, hospitals are given the opportunity to self-identify what level of perinatal service they provide, based on criteria approved by the WAPC Board of Directors. The criteria were adapted from the AAP levels of care--I, IIA, IIB, IIIA, IIIB, and IIIC.

This self-assessment process is the next step in WAPC's long history of promoting healthy birth outcomes through regionalized perinatal care. The ultimate goals of this initiative are to:

  1. Establish a consistent set of minimum expectations for each level of perinatal services.
  2. Enable each institution to provide consumers with a consistent level and quality of perinatal services.
  3. Recognize the capabilities, commitment and resources of institutions that are beyond the minimum expectation for their level of perinatal services.

Self-Assessment Process Results (NEW)

Self-Assessment Materials
The following list includes all of the necessary documents you will need to complete the self-assessment process.  

icon Self-Assessment Instruction Sheet (110.97 KB)  

icon Application Form (64.78 KB)  

icon Level I (Standard Care) Criteria Worksheet (68.57 KB) 

icon Levels IIA & IIB (Specialty Care) Criteria Worksheet (88.92 KB)  

icon Levels IIIA, IIIB, & IIIC (Subspecialty Care) Criteria Worksheet (106.29 KB)  

icon Appendix 1: Staffing Ratios Worksheet (25.39 KB) [Adapted from Table 2-1 in Guidelines for Perinatal Care (5th ed.), p. 24.]

icon Appendix 2: Laboratory Services Worksheet (67.09 KB) [Note: For Level 2, all services in Level 1 column must be available and for Level 3, all services in Level 1 and Level 2 columns must be available.]

icon Appendix 3: Facility Policies Worksheet (Required for Level I, IIA, IIB, and IIIA facilities) (20.24 KB)
 
Contact Information
If you have questions about the assessment process, contact WAPC staff at

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