In New York, the rate of opioid overdose deaths for women aged 18-44 tripled between 2010 and 2016. In response, the New York State Perinatal Quality Collaborative (NYSPQC) implemented the AIM Obstetric Care for Women with Opioid Use Disorder Patient Safety Bundle through the NYS Opioid Use Disorder in Pregnancy & Neonatal Abstinence Syndrome Project. The NYSPQC provides participating birthing facilities with education, data collection and analysis, and other clinical and quality improvement support. The project began as a pilot in September 2018 with 15 birthing hospitals participating and expanded in December 2020. As of the project close in June 2023, 41 of the state’s 119 birthing facilities were participating. The percentage of birthing facilities that had a unit standard policy to screen every person giving birth for substance use disorder increased from 20% in January 2019 to 93% in May 2023 among the 15 hospitals participating in the pilot phase and from 40% in December 2020 to 96% to in May 2023 among the 26 hospitals participating in the expansion phase. Additionally, the percentage of pregnant and postpartum people with opioid use disorder with existing referral or linkage to medication-assisted treatment or behavioral health treatment on admission increased from 73% to 91% among pilot phase hospitals and from 64% to 100% among expansion phase hospitals, between December 2020 and May 2023.