NYS Breastfeeding Collaborative Welcomes New Hospitals

Posted May 26, 2016 by Josh Grant

Mother Nursing Newborn Infant
21 hospitals in New York are improving their breastfeeding practices. 
More mothers in New York will soon experience better improvements in hospital maternity care, as 21 more hospitals join the state’s Breastfeeding Quality Improvement in Hospitals Collaborative (BQIH). Cohort A saw 12 New York hospitals work together and use quality improvement (QI) methods to change their systems and practices to better support a mothers choice to breastfeedings. Cohort B will see 21 new hospitals participate in the collaborative, building off the momentum and learnings from their predecessors. 

Jayne Charlamb, MD, FACP, IBCLC, division chief of Breast Health and Breastfeeding Medicine at SUNY Upstate Medical University and faculty member for BQIH, recently sat down with us to talk about the successes and challenges of Cohort A and how they’ll affect Cohort B. 

Working Together, Apart
The cohort conducted two in-person learning sessions, and used virtual meetings to create lines of communication between the teams. 

The in-person meetings helped build some of that engagement and foster communication among the teams, which were spread geographically apart. Hospitals started emailing each other and reaching out directly rather than waiting for the next learning session. NICHQ’s Collaboratory (CoLab), an online platform for sharing information and data, also became a great resource for asking questions and offering suggestions. Teams would ask how to address issues within different patient populations and their peers would provide possible solutions based on previous experiences.

“This is something we’ll stress right up front with Cohort B: ‘If you need help, the CoLab is the place to go to find it and get answers,’” Charlamb hopes. “We’re also brainstorming ways to maximize engagement offline, such as sending individual faculty members out to hospitals or encouraging hospitals that are near each other to do the sessions together.”

Setting the Right Goals and Achieving Them
One of the biggest challenges facing the cohort was the goals each hospital wanted to achieve. Some facilities had high expectations for large, immediate changes. During the first learning session, these hospitals were eager to start on a systems level, and they needed to learn that working on a small scale could lead to large improvements down the road, says Charlamb. 

“We were able to help the teams focus by starting small: one baby, one mom, one trial,” says Charlamb. “The teams were able to take that advice and focus their energy onto something small and meaningful, and through coordination and determination they started making real change.”

Starting small led to rapid progress and major, sustained success. Charlamb noted that the cohort started by focusing on skin-to-skin contact between moms and babies after vaginal births. By the fifth month, the hospitals reported a skin-to-skin contact rate of 89 percent. This eventually affected other practices, with increases in rates of skin-to-skin contact after cesarean sections and breastfeeding initiated within an hour of birth coming shortly thereafter.

Run Chart of Breastfeeding Measure

Mentoring New Participants
Just as in Cohort A, NICHQ staff and the faculty will guide and assist Cohort B’s participants through QI work and steer them towards innovative, collaborative approaches to enhance breastfeeding systems. But there will also be some other role models involved: Some Cohort A participants will stay on as mentors, further easing the learning curve. 

“Having mentor hospitals from CoHort A can really help CoHort B move into this more quickly and adapt to working in a cohort,” Charlamb said. “The mentors will benefit too because they’ll stay focused on breastfeeding practices and won’t regress.”

As BQIH progresses, faculty members and NICHQ staff will be able to help hospitals build off previous successes and tackle known challenges. Their experience and dedication will help New York hospitals improve their maternity care practices and better support moms and babies.

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