Supporting Breastfeeding Across A Hospital System

Posted January 04, 2016 by Wendy Loveland

Asian woman holding a clipboard in the hospital
Hospitals systems are finding big benefits from the guidance their hospital system predecessors are providing in implementing Baby-Friendly procedures.
Changing a habit is not easy, even when you know it is “good for you.” The same goes for changing healthcare systems.

The benefits of breastfeeding are well known, and supported by the World Health Organization, the Joint Commission, and many other healthcare accreditation and oversight agencies and experts. However, many hospitals struggle to create environments that support mothers who choose to breastfeed.

In Texas, NICHQ is using a learning collaborative approach to help hospitals and birthing centers change their practices so that they can better support mothers who choose to breastfeed. The Texas Ten Step Star Achiever Breastfeeding Learning Collaborative, which is a complementary program to the state’s Texas Ten Step Program, started in 2012 and is in its third and final round of hospital groupings (known as cohorts). Hospitals participating in this third cohort, which belong to a health system, are finding big benefits from the guidance their hospital system predecessors are providing.

“I had been a labor and delivery nurse for 27 years. I knew first-hand the benefits of breastfeeding and saw that mothers wanted to breastfeed, but needed more support,” says Dolly Dickson, MHA, BSN, RN, Manager-Women’s Services at CHRISTUS Spohn Hospital Alice. “I completed our facility’s application to Texas Ten Step in late fall 2013. Currently we are pending designation. We continue to work on implementing the Ten Steps, but now we have more resources, including the NICHQ collaborative and most recently, a mentor.”

Stacie Jones, RNC, BSN, IBCLC, is the lead lactation consultant at CHRISTUS Southeast Texas-St. Elizabeth and was team lead when the hospitals participated in the second cohort of the Texas Breastfeeding Learning Collaborative. Jones is now a mentor to three other CHRISTUS hospitals participating in the third cohort, and is using her experience to help these hospitals spread breastfeeding support further across the CHRISTUS system.

“Stacie’s help is tremendous,” says Rebecca Barr, RN, BSN, nurse manager of the newborn nursery and neonatal intensive care unit (NICU) at CHRISTUS St. Michael Health System. “She has already helped us update policies, or has just given us what she has already done, so we don’t have to recreate the wheel. There are many challenges and changes every day. To have a mentor you can call anytime to help make your goals a reality is priceless.”

Dickson adds, “Stacie just shared with us her system policies, protocols and flow sheets. It is incredibly helpful.”

One benefit to making changes system-wide is that changes can be made to policies and procedures that affect the whole system. Changes can even be made to the electronic medical record screens. The latter helps data collection and reporting and also helps to remind staff of the steps to take as they implement evidence-based care into their longstanding routines. In addition, hospitals are able to share information and consult with each other as they have the same goals.

“As a system, we have gone from competitive to collaborative, thus implementing these practice changes as a team has been very successful and rewarding,” says Jones. “Our sister hospitals are facing some of the same challenges we have already overcome. It makes sense to share what strategies were effective and successful in our journey through the Ten Steps to Successful Breastfeeding.”

It takes time and perseverance to change a culture. However, the following are some “quick wins” and other advice for making system change from collaborative participants:
  • Formulate a strong, passionate team which is willing to step out and create change among resistance
  • Discuss the Joint Commission’s Perinatal Core Measure on Exclusive Breastfeeding with your CEO. Meeting this measure results in increased reimbursement.
  • Find someone who has “been there, done that.” Don’t reinvent the wheel.
  • Show staff members the evidence. Put up posters in all patient care areas promoting the Ten Steps. Use the tools that your state’s initiative can give you.
  • Review goals and improvement plans with management first—the CNO and department managers. Then focus on staff training.
  • Start a conversation with your obstetricians about including breastfeeding education in their prenatal visits. Your state may have a toolkit to give to patients. Have an educator talk to patients about breastfeeding during their prenatal visits.
  • Discuss the American Academy of Pediatrics’ policy on breastfeeding with your pediatricians. If their governing body is on board, it helps get physicians on board.
  • Have a distinct goal/aim and keep monthly data to monitor and share improvement (wins) with staff and management. 
  • Persevere! Take it one win at a time and be proud of the steps you have already made.
Mentorship is a part of a collaborative approach that helps systems change. It may still be hard work, but it is worth the effort.

“Before I had the support of the Texas Ten Step program and NICHQ’s collaborative, I was the only one trying to encourage more breastfeeding in my hospital,” remembers Liza Naranjo, BSN, RN, IBCLC, a lactation consultant and Women’s Services Patient Educator at Texas’ CHRISTUS Spohn South Hospital. “But, you can’t do this alone and be successful. Support from other CHRISTUS hospitals, especially ones that have already been through this process, is critical.”



Learn more about NICHQ’s breastfeeding work and how you can partner with NICHQ to help your hospital to improve maternity care practices.

Share:

Add your comment

 
 

 

Archive

Tagcloud

epilepsy QI data AAP early childhood eccs coiin quality improvement pdsas breastfeeding wic texas community support learning session IM CoIIN infant mortality children's health new technology engineering transgender collaboration collaborative learning engagement planning PDSA planning paralysis underplanning analysis paralysis vision eye health smoking smoke-free housing second-hand smoke nichq toolkit e-module infant health dental care oral health underserved populations health inequity public health Maternal and Child Health Journal tips leadership engagement Sickle cell disease indiana SCD medicaid perinatal regionalization safe sleep sudden infant death syndrome national birth defects prevention month birth defects pregnancy planning one key question prepregnancy health preconception health public breastfeeding support family engagement families patients experts insights CHOPT childhood obesity innovation food desert telemedicine TBLC breastfeeding supporting preterm birth prematurity racial disparities audiology ehdi follow-up illinois talana hughes vulnerable populations sports asthma soccer basketball obesity football SIDS Pokemon Go gamification smartphones interconception care birth spacing NASHP issue brief contraceptive use postpartum care CoIN HRSA early childhood trauma NHSA community health consumer advocacy womens health interconception health teenage health PATCH wisconsin missouri risk appropriate care community health workers SCD< infographic infant mortality awareness month inspirations childrens health national breastfeeding month maternal health patient engagement hearing loss hearing treatment pediatric vision vision screening eyesight pre-term birth early-term birth SCD clinic los angeles LOCATe CDC levels of care neonatal care maternal care smoking cessation project safe sleep practices neonatal abstinence syndrome NAS opioids maternal and child health MCH Family voices quality care mental health hydroxyurea SCDTDP men dads testing change data sharing state government city government apps sleep AJPM preconception care senior leadership breastfeeding support video series health equity health disparities access New York BQIH exclusive breastfeeding LARC long-acting reversible contraception unplanned pregnancies social determinants of health health innovations Best Babies Zone CoIIN baby boxes Rhode Island progesterone rooming-in Baby-Friendly parent partner patient and family engagement healthy weight healthy lifestyles primary care telementoring ECHO video conferencing socioemotional health childhood development pediatric Tennessee interview National Coordinating and Evaluation Center medical-legal partnerships mobile app disparities perinatal care overweight obese healthy weight clinic wellness pilot sites data collection education resources paternal engagement risk-appropriate care preterm infants high-risk babies Ten Steps public relations social movement reversible contraceptives medical home pediatric medical home patient transformation facilitator PTF skin-to-skin rooming in prenatal smoking information visualization charts SUID postpartum new mother webinar AMCHP QI Tips ongoing improvement fourth trimester partnership quality and safety coaching PDSA Cycle leadership support year end holiday message reflections gratitute Medicaid data doctor relationship PQC perinatal quality collaboratives vision care vision health evidence-based guidelines ASH health and wellness healthy living healthy eating home visitors home visiting programs March of Dimes APHA results evaluation supplementation formula reduction video infant loss social media advocacy leadership Berns Best Fed Beginnings Ten Steps to Successful Breastfeeding sustainability stress prenatal care data capacity epidemiologists surveillance data PFAC community partners preconception and interconception care motivational interviewing Native Americans ADHD NICHQ Vanderbilt Assessment Scale ADHD Toolkit system design care coordination skin to skin newborn screening ASTHO reduce smoking aim statement safe birth Texas Ten Step skin-to-skin contact 10 Steps staff training small tests acute care mother-baby couplet collective impact population health preconception Newborn Screening Program substance abuse breast milk formula milk bank crisis Huffington Post fundraising campaign first responders NYC improvement healthcare health system sickle cell diease treatment protocol family health partner maternity care Collaborative Improvement and Innovation Network Health Outcomes Measurement Cross-Sector Collaboration Knowledge Sharing Child Health Systems Design systems change